Healthcare Provider Details

I. General information

NPI: 1730506916
Provider Name (Legal Business Name): LANNAH LORRAINE LIM LUA-MAILLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2014
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 SMOKE RANCH RD STE 200
LAS VEGAS NV
89128-0373
US

IV. Provider business mailing address

7500 SMOKE RANCH RD STE 200
LAS VEGAS NV
89128-0373
US

V. Phone/Fax

Practice location:
  • Phone: 702-233-0727
  • Fax:
Mailing address:
  • Phone: 702-233-0727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number18213
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number26204
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: