Healthcare Provider Details

I. General information

NPI: 1679421465
Provider Name (Legal Business Name): MY LV NP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 09/09/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8488 ROZITA LEE AVE BLDG 3 SUITE 100
LAS VEGAS NV
89113-4772
US

IV. Provider business mailing address

1887 WHITNEY MESA DR # 1911
HENDERSON NV
89014-2069
US

V. Phone/Fax

Practice location:
  • Phone: 702-518-2384
  • Fax:
Mailing address:
  • Phone: 702-518-2384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SANDY TRAN
Title or Position: MANAGING/AUTHORIZED OFFICIAL
Credential: APRN, FNP-BC
Phone: 702-518-2384