Provider Demographics
NPI:1164307435
Name:MALDONADO, NATALIE BREANN (RN)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:BREANN
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 FAIRCHILD ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-1811
Mailing Address - Country:US
Mailing Address - Phone:702-886-9300
Mailing Address - Fax:
Practice Address - Street 1:250 PILOT RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-3542
Practice Address - Country:US
Practice Address - Phone:702-982-3292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV892406163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics