MEDICARE: AMBER EGAN

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	175F00000X	Naturopath

General Provider Information

NPI Number	:	1336082767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER EGAN

Provider Business Mailing Address
First Line	:	2615 S TENAYA WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2917
Country	:	US
Telephone Number	:	512-970-4331
Fax Number	:

Provider Business Practice Location Address
First Line	:	5166 W PATRICK LN STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2842
Country	:	US
Telephone Number	:	702-625-2176
Fax Number	:

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

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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Directions to “ AMBER EGAN ” Practice Location

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