Provider Demographics
NPI:1235966177
Name:CAPALLA, LUZELLE KALACAS (APRN)
Entity type:Individual
Prefix:MRS
First Name:LUZELLE
Middle Name:KALACAS
Last Name:CAPALLA
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:7318 AGAPANTHUS CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-3209
Mailing Address - Country:US
Mailing Address - Phone:209-201-5775
Mailing Address - Fax:
Practice Address - Street 1:2839 SAINT ROSE PKWY STE 130
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4849
Practice Address - Country:US
Practice Address - Phone:702-558-4027
Practice Address - Fax:702-558-4028
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-16
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV881130363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner