1497091870 NPI number — MRS. RACHEL ANN LUNINI PA-C

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497091870 NPI number — MRS. RACHEL ANN LUNINI PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LUNINI
Provider First Name:
RACHEL
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GIBSON
Provider Other First Name:
RACHEL
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
PA-C
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1497091870
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1701 BEARDEN DRIVE SUITE 200
Provider Second Line Business Mailing Address:
APEX MEDICAL CENTER
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89106
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-310-9110
Provider Business Mailing Address Fax Number:
702-310-9114

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1701 BEARDEN DR. SUITE 200
Provider Second Line Business Practice Location Address:
APEX MEDICAL CENTER
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-310-9110
Provider Business Practice Location Address Fax Number:
702-310-9114
Provider Enumeration Date:
12/12/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  PA1400 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363AM0700X , with the licence number: PA1400 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: PR01827 . This is a "PHARMACY PRESCRIBE LIC #" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: CS20685 . This is a "NEVADA PHARMACY LIC #" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".




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