MEDICARE: TAYLOR NICOLE PEASE

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	106S00000X	Behavior Technician		NV

General Provider Information

NPI Number	:	1376183913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR NICOLE PEASE

Provider Business Mailing Address
First Line	:	3037 E WARM SPRINGS RD STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3759
Country	:	US
Telephone Number	:	702-780-8447
Fax Number	:	702-780-8491

Provider Business Practice Location Address
First Line	:	3037 E WARM SPRINGS RD STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3759
Country	:	US
Telephone Number	:	702-780-8447
Fax Number	:	702-780-8491

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

Provider Enumeration Date	:	01/12/2020
Last Update Date	:	09/18/2024

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Directions to “ TAYLOR NICOLE PEASE ” Practice Location

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