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NPI Code Detail

MEDICARE: JULIE EDINGTON BAGLEY RN

MEDICARE:   JULIE  EDINGTON BAGLEY  RN
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
1163W00000XRegistered Nurse26966NV

General Provider Information

NPI Number : 1861077760
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE EDINGTON BAGLEY RN
Provider Business Mailing Address
First Line : 2821 W HORIZON RIDGE PKWY STE 101
Second Line :
City : HENDERSON
State : NV
Zip : 89052-4429
Country : US
Telephone Number : 702-893-3333
Fax Number : 702-893-0960
Provider Business Practice Location Address
First Line : 2235 E FLAMINGO RD STE 170
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-5186
Country : US
Telephone Number : 702-893-3333
Fax Number : 702-893-0960
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2021
Last Update Date : 03/11/2021

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Directions to “ JULIE EDINGTON BAGLEY RN” Practice Location

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