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General NPI Number Information
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NPI Number | 1356013734
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Entity Type | Individual
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Provider Name | MEGHAN KAYLEA RAISLEY AU.D
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Gender | Female
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Dates
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Enumeration Date | 10/04/2021
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Last Update Date | 10/04/2021
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Provider Practice Location Address
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Address Line | 6900 N PECOS RD
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89086-4400
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Country | US
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Telephone | 702-791-9059
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Fax |
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Provider Business Mailing Address
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Address Line | 1926 FEATHERBROOK AVE
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89031-5054
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Country | US
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Telephone | 970-397-2251
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | A-3136
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License Number State | NV
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