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NPI Code Detail

MEDICARE: STACY T TRAN LSW

MEDICARE:   STACY T TRAN  LSW
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
1104100000XSocial WorkerS5167NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1S5167OTHERNVNEVADA LSW LICENSE

General Provider Information

NPI Number : 1407181746
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACY T TRAN LSW
Provider Business Mailing Address
First Line : 5400 S RAINBOW BLVD
Second Line : SPRING VALLY HOSPITAL
City : LAS VEGAS
State : NV
Zip : 89118-1859
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5400 S RAINBOW BLVD
Second Line : SPRING VALLY HOSPITAL
City : LAS VEGAS
State : NV
Zip : 89118-1859
Country : US
Telephone Number : 702-853-3000
Fax Number : 702-853-8842
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2009
Last Update Date : 10/05/2009

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Directions to “ STACY T TRAN LSW” Practice Location

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