MEDICARE: NANETTE B. BAME R.D.

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	426998	NV
2	133V00000X	Registered Dietitian	32479-DI-5	NV

General Provider Information

NPI Number	:	1336388487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANETTE B. BAME R.D.

Provider Business Mailing Address
First Line	:	6220 ARLINGTON AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-2565
Country	:	US
Telephone Number	:	702-606-7546
Fax Number	:

Provider Business Practice Location Address
First Line	:	3460 W CHEYENNE AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-8241
Country	:	US
Telephone Number	:	702-883-2838
Fax Number	:

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

Provider Enumeration Date	:	02/12/2009
Last Update Date	:	03/05/2024

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