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NPI Code Detail

MEDICARE: MISS EVELYN FAYE GARDNER LVN

MEDICARE: MISS EVELYN FAYE GARDNER LVN
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
1164X00000XLicensed Vocational NurseVN202744CA
2164W00000XLicensed Practical Nurse15803NV

General Provider Information

NPI Number : 1154618668
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS EVELYN FAYE GARDNER LVN
Provider Business Mailing Address
First Line : 730 CANIELD POINT AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148
Country : US
Telephone Number : 562-396-3939
Fax Number :
Provider Business Practice Location Address
First Line : 3930 HOWARD HUGHES PKWY STE 300
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-0946
Country : US
Telephone Number : 702-560-2192
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2011
Last Update Date : 05/14/2025

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Directions to “ MISS EVELYN FAYE GARDNER LVN” Practice Location

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