MEDICARE: SIRANUSH KHALADZHYAN APRN

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	363L00000X	Nurse Practitioner	855350	NV

General Provider Information

NPI Number	:	1427780030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIRANUSH KHALADZHYAN APRN

Provider Business Mailing Address
First Line	:	1452 W HORIZON RIDGE PKWY STE 566
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89012-4422
Country	:	US
Telephone Number	:	702-800-7831
Fax Number	:	877-409-2014

Provider Business Practice Location Address
First Line	:	8297 PALACE HEIGHTS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-9151
Country	:	US
Telephone Number	:	702-800-7831
Fax Number	:	877-409-2014

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

Provider Enumeration Date	:	06/30/2022
Last Update Date	:	04/09/2026

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