MEDICARE: DR. LAUREL ANNE NEVILLE MD

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	207Q00000X	Family Medicine Physician	22233	NV
2	207Q00000X	Family Medicine Physician	LL3317	NV
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1992264972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAUREL ANNE NEVILLE MD

Provider Business Mailing Address
First Line	:	6213 CROMWELL AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-2527
Country	:	US
Telephone Number	:	559-202-8781
Fax Number	:

Provider Business Practice Location Address
First Line	:	2202 W CRAIG RD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-3018
Country	:	US
Telephone Number	:	27-826-3200
Fax Number	:

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

Provider Enumeration Date	:	03/18/2019
Last Update Date	:	03/27/2025

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