MEDICARE: EVELYN REYES FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	817579	NV
2	363LF0000X	Family Nurse Practitioner	817579	NV

General Provider Information

NPI Number	:	1093271132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVELYN REYES FNP

Provider Business Mailing Address
First Line	:	4020 E RUSSELL RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3802
Country	:	US
Telephone Number	:	702-780-1313
Fax Number	:	702-476-9073

Provider Business Practice Location Address
First Line	:	4020 E RUSSELL RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3802
Country	:	US
Telephone Number	:	702-780-1313
Fax Number	:	702-476-9073

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2019
Last Update Date	:	05/22/2026

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Directions to “ EVELYN REYES FNP” Practice Location

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