Healthcare Provider Details

I. General information

NPI: 1578351482
Provider Name (Legal Business Name): EMILY PAYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2025
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 E FLAMINGO RD STE H
LAS VEGAS NV
89121-5208
US

IV. Provider business mailing address

2950 E FLAMINGO RD STE H
LAS VEGAS NV
89121-5208
US

V. Phone/Fax

Practice location:
  • Phone: 702-251-3854
  • Fax:
Mailing address:
  • Phone: 702-251-3854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number888406
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: