Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Rennette Tiamson Bulatao, NURSEPRACTITIONER

Individual provider Gerontology Nurse Practitioner · NPI 1285364877

Rennette Tiamson Bulatao, NURSEPRACTITIONER is a Nurse Practitioner in Las Vegas, Nevada. Qualified in 2021, 5 years ago. Practices with Optum Medical Group II Rhodes P C, a 302-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Nevada.

Years since qualifying
5
Licensed in
NV
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

4475 S Eastern Ave
Las Vegas, NV 89119-7826
Phone: (702) 877-5119
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 815814 (NV)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 815814 (NV)

Record details

NPI number1285364877
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorYes
NPI enumeratedJune 15, 2022
Last updated in NPPESApril 9, 2026
Certification dateApril 9, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Optum Medical Group Ii Rhodes P C — 302 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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