Healthcare Provider Details

I. General information

NPI: 1952844664
Provider Name (Legal Business Name): SHIRLEY MOORJANI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2016
Last Update Date: 08/31/2022
Certification Date: 08/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2870 S MARYLAND PKWY STE 200
LAS VEGAS NV
89109-1580
US

IV. Provider business mailing address

2870 S MARYLAND PKWY STE 200
LAS VEGAS NV
89109-1580
US

V. Phone/Fax

Practice location:
  • Phone: 702-703-1950
  • Fax: 702-442-9793
Mailing address:
  • Phone: 702-703-1950
  • Fax: 702-442-9793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number002031
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN002031
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: