Healthcare Provider Details

I. General information

NPI: 1962048520
Provider Name (Legal Business Name): SHAYNE PREYER MSN, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHAYNE RAMOS PREYER MSN, APRN, FNP-BC

II. Dates (important events)

Enumeration Date: 11/19/2019
Last Update Date: 11/10/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 MARKS ST.
HENDERSON NV
89014
US

IV. Provider business mailing address

525 MARKS ST.
HENDERSON NV
89014
US

V. Phone/Fax

Practice location:
  • Phone: 702-383-6210
  • Fax: 702-435-7050
Mailing address:
  • Phone: 702-383-6210
  • Fax: 702-435-7050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN61380
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number826577
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: