MEDICARE: HOLLY ANNE SUTTON

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	171100000X	Acupuncturist	2043	NV

General Provider Information

NPI Number	:	1669033379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY ANNE SUTTON

Provider Business Mailing Address
First Line	:	2217 FAWN RIDGE ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-2580
Country	:	US
Telephone Number	:	702-595-1694
Fax Number	:

Provider Business Practice Location Address
First Line	:	2217 FAWN RIDGE ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-2580
Country	:	US
Telephone Number	:	702-595-1694
Fax Number	:

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

Provider Enumeration Date	:	06/24/2019
Last Update Date	:	06/03/2026

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Directions to “ HOLLY ANNE SUTTON ” Practice Location

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