Healthcare Provider Details

I. General information

NPI: 1518831536
Provider Name (Legal Business Name): BRANDY MEBANE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2025
Last Update Date: 10/24/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 N PECOS RD
N LAS VEGAS NV
89086-4400
US

IV. Provider business mailing address

8154 SKYE QUARRY ST
LAS VEGAS NV
89166-1221
US

V. Phone/Fax

Practice location:
  • Phone: 702-465-0119
  • Fax:
Mailing address:
  • Phone: 702-465-0119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberRN95714
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: