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General NPI Number Information
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NPI Number | 1619174422
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Entity Type | Individual
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Provider Name | MEGAN E MILLOY PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 11/10/2011
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Provider Practice Location Address
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Address Line | 2704 N TENAYA WAY
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City | LAS VEGAS
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State | NV
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Zip | 89128-0424
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Country | US
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Telephone | 702-243-8525
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Fax | 702-636-8753
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Provider Business Mailing Address
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Address Line | PO BOX 15645
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City | LAS VEGAS
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State | NV
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Zip | 89114-5645
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Country | US
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Telephone | 702-560-2900
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Fax | 702-560-2928
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA1130
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License Number State | NV
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