MEDICARE: MS. SHINLY MARIE KARL PANGILINAN NP-C

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	363LF0000X	Family Nurse Practitioner	815071	NV

General Provider Information

NPI Number	:	1477023067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHINLY MARIE KARL PANGILINAN NP-C

Provider Business Mailing Address
First Line	:	6950 W DESERT INN RD STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-3171
Country	:	US
Telephone Number	:	702-259-5550
Fax Number	:	702-259-5554

Provider Business Practice Location Address
First Line	:	6950 W DESERT INN RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-3171
Country	:	US
Telephone Number	:	702-259-5550
Fax Number	:	702-259-5554

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

Provider Enumeration Date	:	11/27/2018
Last Update Date	:	07/26/2019

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