MEDICARE: KAI MALOY

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	164W00000X	Licensed Practical Nurse	885412	NV

General Provider Information

NPI Number	:	1558203794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAI MALOY

Provider Business Mailing Address
First Line	:	10745 PASSION HEIGHTS ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89179-1492
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10745 PASSION HEIGHTS ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89179-1492
Country	:	US
Telephone Number	:	872-232-0614
Fax Number	:	872-232-0614

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

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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Directions to “ KAI MALOY ” Practice Location

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