MEDICARE: SARAH NGUYEN 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	PA1379	NV

General Provider Information

NPI Number	:	1134504178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH NGUYEN PA-C

Provider Business Mailing Address
First Line	:	2057 CHERRY CREEK CIR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-1567
Country	:	US
Telephone Number	:	702-743-2303
Fax Number	:

Provider Business Practice Location Address
First Line	:	6539 LAS VEGAS BLVD S
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-3222
Country	:	US
Telephone Number	:	702-701-6708
Fax Number	:

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

Provider Enumeration Date	:	07/20/2015
Last Update Date	:	07/20/2015

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Directions to “ SARAH NGUYEN PA-C” Practice Location

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