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NPI Code Detail

MEDICARE: SYDNEY LAUREN EGAN APRN

MEDICARE: SYDNEY LAUREN EGAN APRN
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner818676NV

General Provider Information

NPI Number : 1396203758
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYDNEY LAUREN EGAN APRN
Provider Business Mailing Address
First Line : 112 S JONES BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89107-2614
Country : US
Telephone Number : 702-909-4600
Fax Number :
Provider Business Practice Location Address
First Line : 112 S JONES BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89107-2614
Country : US
Telephone Number : 702-909-4600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2019
Last Update Date : 12/26/2021

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