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NPI Code Detail

MEDICARE: TRYSTON STEVENS

MEDICARE:   TRYSTON  STEVENS
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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1871398180
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRYSTON STEVENS
Provider Business Mailing Address
First Line : 2533 NATALIE AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-2131
Country : US
Telephone Number : 23-578-3177
Fax Number : 702-357-8317
Provider Business Practice Location Address
First Line : 2533 NATALIE AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-2131
Country : US
Telephone Number : 23-578-3177
Fax Number : 702-357-8317
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2025
Last Update Date : 02/19/2025

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Directions to “ TRYSTON STEVENS ” Practice Location

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