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NPI Code Detail

MEDICARE: MS. AMANDA NICOLE SQUIERS ANP-BC

MEDICARE: MS. AMANDA NICOLE SQUIERS ANP-BC
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
1363LA2200XAdult Health Nurse PractitionerAP61623307WA
2363LA2200XAdult Health Nurse Practitioner201404840NP-PPOR
3363LA2200XAdult Health Nurse PractitionerAPN13902TN
4363LA2200XAdult Health Nurse Practitioner825927NV

General Provider Information

NPI Number : 1184860983
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMANDA NICOLE SQUIERS ANP-BC
Provider Business Mailing Address
First Line : 7150 W SUNSET RD STE 201A
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-1981
Country : US
Telephone Number : 702-385-4342
Fax Number : 702-442-1886
Provider Business Practice Location Address
First Line : 7500 SMOKE RANCH RD STE 200
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-0373
Country : US
Telephone Number : 702-233-4727
Fax Number : 702-233-4799
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2008
Last Update Date : 12/16/2024

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1245242957 — OMID LESANI M.D.
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1720173602 — VICTOR E. GRIGORIEV M.D.
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1699053660 — ADELBERT SCOTT WADSWORTH PA-C
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1972944494 — STEPHEN JOSEPH DELCASINO JR. PA-C
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Directions to “ MS. AMANDA NICOLE SQUIERS ANP-BC” Practice Location

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