Individual ProviderMa Teresa MercadoNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address601 S Rancho R D, Ste D28, Las Vegas, NV 89106-4827(702) 473-5495PECOS EnrollmentBased on the most recent information from CMS, provider Ma Teresa Mercado is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1235984931Provider TypeIndividualFull NameMercado, Ma TeresaCredentialAPRNGenderFemaleSole ProprietorYesEnumeration Date4/17/2024Last Updated11/8/2024Contact InformationPractice LocationPractice Address601 S Rancho R D, Ste D28, Las Vegas, NV 89106-4827Phone(702) 473-5495Fax(702) 473-5506Mailing LocationMailing Address840 S Rancho Dr Ste 4-423, Las Vegas, NV 89106-3837Phone(702) 473-5495Fax(702) 473-5506Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense818339Nevada