MEDICARE: MYENP LLC

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	363LP2300X	Primary Care Nurse Practitioner

General Provider Information

NPI Number	:	1295685857
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MYENP LLC

Provider Business Mailing Address
First Line	:	10305 BIRCH BLUFF LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-8830
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10305 BIRCH BLUFF LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-8830
Country	:	US
Telephone Number	:	725-294-2507
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER
Name	:	MYLENE AGREDA
Credential	:	APRN
Telephone Number	:	702-883-6821

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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Directions to “MYENP LLC ” Practice Location

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