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General NPI Number Information
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NPI Number | 1760977029
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Entity Type | Individual
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Provider Name | ERIN LIN MIYASHIRO FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/28/2018
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Last Update Date | 10/02/2023
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Provider Practice Location Address
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Address Line | 1000 S RAINBOW BLVD STE B
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City | LAS VEGAS
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State | NV
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Zip | 89145-6231
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Country | US
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Telephone | 702-255-4200
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Fax | 702-255-0260
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Provider Business Mailing Address
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Address Line | 6355 S BUFFALO DR FL 3
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City | LAS VEGAS
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State | NV
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Zip | 89113-2133
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Country | US
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Telephone | 702-216-3346
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Fax | 702-671-6883
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 03614
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 830871
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License Number State | NV
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