=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447490503
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NATALIE ANN KHUU PA-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/03/2009
-----------------------------------------------------
Last Update Date | 12/31/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8828 MOHAWK ST STE 201
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89139-7011
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-342-5390
-----------------------------------------------------
Fax | 702-342-5399
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2380 W HORIZON RIDGE PKWY STE 110
-----------------------------------------------------
City | HENDERSON
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89052-5078
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-823-4255
-----------------------------------------------------
Fax | 702-475-3261
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363AM0700X
-----------------------------------------------------
Taxonomy Name | Medical Physician Assistant
-----------------------------------------------------
License Number | PA3118
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------