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General NPI Number Information
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NPI Number | 1942291448
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Entity Type | Individual
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Provider Name | CAROLYN ANN CRUVANT M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/02/2005
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Last Update Date | 03/29/2023
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Provider Practice Location Address
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Address Line | 3575 PECOS MCLEOD
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City | LAS VEGAS
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State | NV
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Zip | 89121-3803
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Country | US
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Telephone | 702-731-2088
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Fax | 702-734-7836
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Provider Business Mailing Address
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Address Line | 50 S STEPHANIE ST STE 101
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City | HENDERSON
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State | NV
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Zip | 89012-5731
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Country | US
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Telephone | 702-202-4776
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Fax | 702-202-6110
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 5853
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License Number State | NV
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