Individual ProviderRamon AmezcuaNurse 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 Ramon Amezcua does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1881862225Provider TypeIndividualFull NameAmezcua, RamonCredentialFNP-BCGenderMaleSole ProprietorNoEnumeration Date2/20/2008Last Updated4/22/2010Contact InformationPractice LocationPractice Address500 S Rancho Dr, Suite 12, Las Vegas, NV 89106-4844Phone(702) 877-1887FaxUnlisted FaxMailing LocationMailing Address500 S Rancho Dr, Suite 12, Las Vegas, NV 89106-4844Phone(702) 877-1887FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAPN001023Nevada