Individual ProviderKatriella FernandezNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address6064 S Fort Apache Rd Ste 100, Las Vegas, NV 89148-5350(702) 940-8007PECOS EnrollmentBased on the most recent information from CMS, provider Katriella Fernandez is legally eligible to order and refer claims for DME and PMD services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1073169454Provider TypeIndividualFull NameFernandez, KatriellaCredentialFNP-CGenderFemaleSole ProprietorNoEnumeration Date8/12/2019Last Updated4/18/2024Contact InformationPractice LocationPractice Address6064 S Fort Apache Rd Ste 100, Las Vegas, NV 89148-5350Phone(702) 940-8007Fax(702) 832-1940Mailing LocationMailing Address6064 S Fort Apache Rd Ste 100, Las Vegas, NV 89148-5350Phone(702) 940-8007Fax(702) 832-1940Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense823656NevadaCode208VP0014XDescriptionPain MedicineAllopathic & Osteopathic PhysiciansLicense823656NevadaProvider IdentifiersIDDescriptionIssuerID1073169454DescriptionMedicaidIssuerUnlistedNevada