Healthcare Provider Details

I. General information

NPI: 1528721073
Provider Name (Legal Business Name): ANNA LEE KASPER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2021
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2851 N TENAYA WAY
LAS VEGAS NV
89128-0435
US

IV. Provider business mailing address

2851 N TENAYA WAY
LAS VEGAS NV
89128-0435
US

V. Phone/Fax

Practice location:
  • Phone: 702-243-3340
  • Fax: 702-991-3773
Mailing address:
  • Phone: 702-243-3340
  • Fax: 702-991-3773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA2723
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: