Individual ProviderLourdes MendozaNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address500 S Rancho Dr, Suite 12, Las Vegas, NV 89106-4844(702) 877-1887PECOS EnrollmentBased on the most recent information from CMS, provider Lourdes Mendoza 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 ID1851717813Provider TypeIndividualFull NameMendoza, LourdesCredentialAPRNGenderFemaleSole ProprietorYesEnumeration Date3/13/2014Last Updated12/30/2014Contact InformationPractice LocationPractice Address500 S Rancho Dr, Suite 12, Las Vegas, NV 89106-4844Phone(702) 877-1887Fax(702) 877-4536Mailing LocationMailing Address500 S Rancho Dr, Suite 12, Las Vegas, NV 89106-4844Phone(702) 877-1887Fax(702) 877-4536Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAPRN001645Nevada