MEDICARE: MAKON AMAZING GIFTED HANDS PLLC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
2	363LG0600X	Gerontology Nurse Practitioner

General Provider Information

NPI Number	:	1588263248
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAKON AMAZING GIFTED HANDS PLLC

Provider Business Mailing Address
First Line	:	510 E MARDON AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1276
Country	:	US
Telephone Number	:	702-637-7535
Fax Number	:	702-920-7677

Provider Business Practice Location Address
First Line	:	3430 E FLAMINGO RD STE 350
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5067
Country	:	US
Telephone Number	:	702-637-7535
Fax Number	:	702-920-7677

Authorized Official
Title or Position	:	OWNER
Name	:	ROSETTE SANDRINE MAKON
Credential	:	AGNP-C, PMHNP-BC, WC
Telephone Number	:	469-989-2697

Provider Enumeration Date	:	10/22/2020
Last Update Date	:	06/02/2026

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