MEDICARE: MRS. EMILY KELLEIGH PA-C

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
1	363A00000X	Physician Assistant	PA3045	NV

General Provider Information

NPI Number	:	1073010047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EMILY KELLEIGH PA-C

Provider Business Mailing Address
First Line	:	2202 W CRAIG RD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-3018
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2202 W CRAIG RD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-3018
Country	:	US
Telephone Number	:	702-826-3200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2018
Last Update Date	:	10/29/2024

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