MEDICARE: SHARLONA PAYNE APRN

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	363LG0600X	Gerontology Nurse Practitioner	833384	NV

General Provider Information

NPI Number	:	1881201713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARLONA PAYNE APRN

Provider Business Mailing Address
First Line	:	691 N NELLIS BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110-5383
Country	:	US
Telephone Number	:	855-975-5119
Fax Number	:

Provider Business Practice Location Address
First Line	:	691 N NELLIS BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110-5383
Country	:	US
Telephone Number	:	855-975-5119
Fax Number	:

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

Provider Enumeration Date	:	09/24/2020
Last Update Date	:	10/26/2022

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Directions to “ SHARLONA PAYNE APRN” Practice Location

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