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NPI Code Detail

MEDICARE: ELIZABETH SHIN PA-C

MEDICARE: ELIZABETH SHIN PA-C
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
1363A00000XPhysician AssistantNV

General Provider Information

NPI Number : 1811859366
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH SHIN PA-C
Provider Business Mailing Address
First Line : 540 N NELLIS BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-5368
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 540 N NELLIS BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-5368
Country : US
Telephone Number : 702-641-3212
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2025
Last Update Date : 12/02/2025

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Directions to “ ELIZABETH SHIN PA-C” Practice Location

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