MEDICARE: MARY ADDELID BAYOT

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	837799	NV

General Provider Information

NPI Number	:	1619729506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ADDELID BAYOT

Provider Business Mailing Address
First Line	:	1156 VIA MONTICANO
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-1511
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	320 E WARM SPRINGS RD STE 1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4282
Country	:	US
Telephone Number	:	702-602-5250
Fax Number	:	702-602-5251

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

Provider Enumeration Date	:	04/03/2024
Last Update Date	:	10/02/2024

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Directions to “ MARY ADDELID BAYOT ” Practice Location

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