MEDICARE: BRENDA PRATT APN

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	363LF0000X	Family Nurse Practitioner	APRN001831	NV

General Provider Information

NPI Number	:	1881099026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA PRATT APN

Provider Business Mailing Address
First Line	:	3196 S MARYLAND PKWY STE 207
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2313
Country	:	US
Telephone Number	:	702-410-2970
Fax Number	:	702-410-2974

Provider Business Practice Location Address
First Line	:	3196 S MARYLAND PKWY STE 207
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2313
Country	:	US
Telephone Number	:	702-410-2970
Fax Number	:	702-410-2974

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

Provider Enumeration Date	:	10/30/2014
Last Update Date	:	10/30/2014

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Directions to “ BRENDA PRATT APN” Practice Location

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