MEDICARE: SOUTHERN NEVADA HEALTH DISTRICT

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	251B00000X	Case Management Agency	RN23003	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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316368673
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHERN NEVADA HEALTH DISTRICT

Provider Business Mailing Address
First Line	:	400 SHADOW LN
Second Line	:	STE 208
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4363
Country	:	US
Telephone Number	:	702-759-0930
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 SHADOW LN
Second Line	:	STE 208
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4363
Country	:	US
Telephone Number	:	702-759-0930
Fax Number	:

Authorized Official
Title or Position	:	RN CASE MANAGER
Name	:	MS. EDITH C BURNS
Credential	:	REGISTERED NURSE
Telephone Number	:	702-759-0930

Provider Enumeration Date	:	01/03/2014
Last Update Date	:	01/03/2014

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Directions to “SOUTHERN NEVADA HEALTH DISTRICT ” Practice Location

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