Healthcare Provider Details

I. General information

NPI: 1538030713
Provider Name (Legal Business Name): REBECCA TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2025
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1490 W SUNSET RD STE 120
HENDERSON NV
89014-6635
US

IV. Provider business mailing address

1490 W SUNSET RD STE 120
HENDERSON NV
89014-6635
US

V. Phone/Fax

Practice location:
  • Phone: 702-815-7779
  • Fax: 844-389-0835
Mailing address:
  • Phone: 702-815-7779
  • Fax: 844-389-0835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21708
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: