MEDICARE: MR. SHAWN MCGARNETT COLLIER JR.

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	811316	NV

General Provider Information

NPI Number	:	1205794997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SHAWN MCGARNETT COLLIER JR.

Provider Business Mailing Address
First Line	:	5940 S RAINBOW BLVD STE 1014
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2540
Country	:	US
Telephone Number	:	702-899-8212
Fax Number	:	702-901-6088

Provider Business Practice Location Address
First Line	:	5940 S RAINBOW BLVD STE 1014
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2540
Country	:	US
Telephone Number	:	702-899-8212
Fax Number	:	702-901-6088

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

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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