Healthcare Provider Details

I. General information

NPI: 1689097735
Provider Name (Legal Business Name): LYNDA C MCCLOSKEY R.N.,B.S.N.,M.P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2014
Last Update Date: 01/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 SOUTH VALLEY VIEW
LAS VEGAS NV
89110
US

IV. Provider business mailing address

8300 CHAPELLE COURT
LAS VEGAS NV
89131
US

V. Phone/Fax

Practice location:
  • Phone: 702-759-1331
  • Fax: 702-759-1455
Mailing address:
  • Phone: 702-759-1331
  • Fax: 702-759-1455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN27030
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: