Healthcare Provider Details

I. General information

NPI: 1396361689
Provider Name (Legal Business Name): NEVADA FERTILITY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2020
Last Update Date: 06/22/2020
Certification Date: 06/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5320 S RAINBOW BLVD STE 300
LAS VEGAS NV
89118-1896
US

IV. Provider business mailing address

5320 S RAINBOW BLVD STE 300
LAS VEGAS NV
89118-1896
US

V. Phone/Fax

Practice location:
  • Phone: 702-892-9696
  • Fax: 702-892-9666
Mailing address:
  • Phone: 702-892-9696
  • Fax: 702-892-9666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: KRIS PYATT
Title or Position: ADMINISTRATOR
Credential:
Phone: 702-892-9696