MEDICARE: UNITED STATES AIR FORCE

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	286500000X	Military Hospital

General Provider Information

NPI Number	:	1891930244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED STATES AIR FORCE

Provider Business Mailing Address
First Line	:	6501 VEGAS DR APT 1034
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-7773
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6501 VEGAS DR APT 1034
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-7773
Country	:	US
Telephone Number	:	318-347-4651
Fax Number	:

Authorized Official
Title or Position	:	PA STUDENT
Name	:	JASON ROBERT CROCKETT
Credential	:
Telephone Number	:	318-347-4651

Provider Enumeration Date	:	12/12/2008
Last Update Date	:	12/12/2008

Similar Medicare Providers

1477031946 — NICKEA ADANA NIXON
Practice Location Address:

3050 S NELLIS BLVD APT 2142
LAS VEGAS, NV
89121-7773

Practice Phone: 702-659-2822
Practice Fax:

1760320808 — LAS VEGAS GROUP HOME AT LAKE MEAD
Practice Location Address:

5399 W LAKE MEAD BLVD
LAS VEGAS, NV
89108-3051

Practice Phone: 702-806-5947
Practice Fax:

1952004632 — KATHLYNE LEWIS
Practice Location Address:

5900 MARTITA AVE
LAS VEGAS, NV
89108-2478

Practice Phone: 702-544-6826
Practice Fax:

1184572760 — MARIAH DANELL BORGNA QMHA
Practice Location Address:

2901 N RAINBOW BLVD APT 2054
LAS VEGAS, NV
89108-4555

Practice Phone: 661-855-9399
Practice Fax:

1902626211 — CAITLIN AOLANI RUBY PATEY
Practice Location Address:

6444 SAPPHIRE ST
LAS VEGAS, NV
89108-5652

Practice Phone: 571-263-6363
Practice Fax:

1134077902 — MELISSA Y BERRELLEZA
Practice Location Address:

6353 PLAZA VERDE PL
LAS VEGAS, NV
89108-3948

Practice Phone: 702-333-1488
Practice Fax:

Directions to “UNITED STATES AIR FORCE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.