MEDICARE: MARTIN BINYANGE

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN001920	NV

General Provider Information

NPI Number	:	1558757021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTIN BINYANGE

Provider Business Mailing Address
First Line	:	320 E WARM SPRINGS RD, UNIT 1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4243
Country	:	US
Telephone Number	:	702-602-5250
Fax Number	:	702-602-5251

Provider Business Practice Location Address
First Line	:	320 E WARM SPRINGS RD, UNIT 1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4243
Country	:	US
Telephone Number	:	702-602-5250
Fax Number	:	702-602-5251

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

Provider Enumeration Date	:	04/12/2015
Last Update Date	:	06/30/2024

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Directions to “ MARTIN BINYANGE ” Practice Location

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