MEDICARE: REILLY LAYNE WARREN MS, RD, LD

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	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1285593046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REILLY LAYNE WARREN MS, RD, LD

Provider Business Mailing Address
First Line	:	42 KNIGHTSBORO RD
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-6315
Country	:	US
Telephone Number	:	806-470-1422
Fax Number	:	806-470-1422

Provider Business Practice Location Address
First Line	:	42 KNIGHTSBORO RD
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-6315
Country	:	US
Telephone Number	:	806-470-1422
Fax Number	:	806-470-1422

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

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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