MEDICARE: CATHALINE L PEARSON PA-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	363AM0700X	Medical Physician Assistant	PA895	NV
2	363AM0700X	Medical Physician Assistant	PA-C0156	NV
3	363AM0700X	Medical Physician Assistant	2937	AZ

General Provider Information

NPI Number	:	1508821281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHALINE L PEARSON PA-C

Provider Business Mailing Address
First Line	:	PO BOX 34934
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-4934
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9310 S EASTERN AVE
Second Line	:	SUITE 122
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-6843
Country	:	US
Telephone Number	:	702-489-3300
Fax Number	:	702-410-9143

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

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	09/01/2011

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