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NPI Code Detail

MEDICARE: BRYNETTA MORROW PAC

MEDICARE:   BRYNETTA  MORROW  PAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantPA935NV

Other Identifiers

General Provider Information

NPI Number : 1063485480
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYNETTA MORROW PAC
Provider Business Mailing Address
First Line : PO BOX 15645
Second Line :
City : LAS VEGAS
State : NV
Zip : 89114-5645
Country : US
Telephone Number : 702-750-3425
Fax Number : 702-750-3434
Provider Business Practice Location Address
First Line : 8680 W CHEYENNE AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89129-7458
Country : US
Telephone Number : 702-750-3425
Fax Number : 702-750-3434
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2006
Last Update Date : 01/17/2017

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Directions to “ BRYNETTA MORROW PAC” Practice Location

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