MEDICARE: DR. EDWARD DREW SWEETEN JR. RN,RT,NHA,MD

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	163W00000X	Registered Nurse	16526	NV
2	163W00000X	Registered Nurse	RN-064931	AZ
3	2471C3402X	Radiography Radiologic Technologist	RHF 12519	CA
4	2471C3402X	Radiography Radiologic Technologist	CRT-3294	AZ
5	376G00000X	Nursing Home Administrator	174	NV
6	376G00000X	Nursing Home Administrator	384	NM
7	376G00000X	Nursing Home Administrator	662	AZ

General Provider Information

NPI Number	:	1316968852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD DREW SWEETEN JR. RN,RT,NHA,MD

Provider Business Mailing Address
First Line	:	6521 ELTON AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-2413
Country	:	US
Telephone Number	:	702-630-5470
Fax Number	:	702-870-5623

Provider Business Practice Location Address
First Line	:	6521 ELTON AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-2413
Country	:	US
Telephone Number	:	702-630-5470
Fax Number	:	702-870-5623

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

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	09/11/2025

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