MEDICARE: MARGARITA S SHANKS 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	363AM0700X	Medical Physician Assistant	60101218	WA
2	363AM0700X	Medical Physician Assistant	PA2210	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	PA2210	OTHER	NV	STATE LICENSE

General Provider Information

NPI Number	:	1255732483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARITA S SHANKS PA-C

Provider Business Mailing Address
First Line	:	6355 S BUFFALO DR FL 3
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2133
Country	:	US
Telephone Number	:	702-216-3346
Fax Number	:

Provider Business Practice Location Address
First Line	:	1302 W CRAIG RD
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89032-0246
Country	:	US
Telephone Number	:	702-657-9555
Fax Number	:	702-657-9040

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

Provider Enumeration Date	:	09/08/2014
Last Update Date	:	01/06/2025

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Directions to “ MARGARITA S SHANKS PA-C” Practice Location

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