MEDICARE: MRS. TINA MARIE PEARSON CNM

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	367A00000X	Advanced Practice Midwife	APRN.CNM.13352	OH
2	367A00000X	Advanced Practice Midwife	APRN11024039	FL
3	367A00000X	Advanced Practice Midwife	861391	NV

General Provider Information

NPI Number	:	1184983942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TINA MARIE PEARSON CNM

Provider Business Mailing Address
First Line	:	8906 SPANISH RIDGE AVE STE 202
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1319
Country	:	US
Telephone Number	:	702-330-3102
Fax Number	:	702-912-4994

Provider Business Practice Location Address
First Line	:	9280 W SUNSET RD STE 400
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-4862
Country	:	US
Telephone Number	:	702-366-7079
Fax Number	:	702-366-7079

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

Provider Enumeration Date	:	05/14/2012
Last Update Date	:	03/30/2023

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