MEDICARE: MIKAYLA LAUREN WASS FNP

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	363LF0000X	Family Nurse Practitioner	816966	NV

General Provider Information

NPI Number	:	1275360158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIKAYLA LAUREN WASS FNP

Provider Business Mailing Address
First Line	:	1071 ORO WAY
Second Line	:
City	:	GARDNERVILLE
State	:	NV
Zip	:	89460-7515
Country	:	US
Telephone Number	:	775-790-1188
Fax Number	:

Provider Business Practice Location Address
First Line	:	1621 US HIGHWAY 395 N STE 200
Second Line	:
City	:	MINDEN
State	:	NV
Zip	:	89423-4300
Country	:	US
Telephone Number	:	775-369-2106
Fax Number	:

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

Provider Enumeration Date	:	09/16/2024
Last Update Date	:	02/08/2026

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Directions to “ MIKAYLA LAUREN WASS FNP” Practice Location

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