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NPI Code Detail

MEDICARE: QUELYN GAYLE PALISOC

MEDICARE:   QUELYN GAYLE  PALISOC
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
1363LF0000XFamily Nurse Practitioner826579NV

General Provider Information

NPI Number : 1285271379
Entity Type Code : Individual
Provider Name (Legal Business Name) : QUELYN GAYLE PALISOC
Provider Business Mailing Address
First Line : 1800 W. CHARLESTON BLVD. STE. 508
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102
Country : US
Telephone Number : 702-383-2688
Fax Number :
Provider Business Practice Location Address
First Line : 4180 S RAINBOW BLVD STE 809
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-3135
Country : US
Telephone Number : 702-383-3626
Fax Number : 702-383-1883
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2019
Last Update Date : 07/31/2025

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Directions to “ QUELYN GAYLE PALISOC ” Practice Location

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