Provider Demographics
NPI:1760896336
Name:MERCADO, MARCUS ALLAN PERRERAS (FNP-C)
Entity type:Individual
Prefix:MR
First Name:MARCUS ALLAN
Middle Name:PERRERAS
Last Name:MERCADO
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:384 WIND POPPY ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89138-6265
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:384 WIND POPPY ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89138-6265
Practice Address - Country:US
Practice Address - Phone:310-920-1130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-11
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95000176363LF0000X
NV872562363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1607745091OtherNV DRIVERS LICENSE
CANP95000176OtherCA BOARD OF NURSING NP LICENSE #
NV872562OtherNV BOARD OF NURSING NP LICENSE #