MEDICARE: MILTON DY

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	163WE0003X	Emergency Registered Nurse	RN91768	NV
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	332386	AZ
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	886175	NV

General Provider Information

NPI Number	:	1124739735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MILTON DY

Provider Business Mailing Address
First Line	:	7001 DESERT CLOVER CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-5745
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7001 DESERT CLOVER CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-5745
Country	:	US
Telephone Number	:	408-677-9528
Fax Number	:

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

Provider Enumeration Date	:	12/06/2022
Last Update Date	:	12/10/2025

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Directions to “ MILTON DY ” Practice Location

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