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NPI Code Detail

MEDICARE: MRS. SHARIE TYSETTE NELSON

MEDICARE:  MRS. SHARIE TYSETTE NELSON
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1679873533
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHARIE TYSETTE NELSON
Provider Business Mailing Address
First Line : 6767 W TROPICANA AVE STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-4755
Country : US
Telephone Number : 27-209-0370
Fax Number : 702-463-1851
Provider Business Practice Location Address
First Line : 6767 W TROPICANA AVE STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-4755
Country : US
Telephone Number : 702-209-0370
Fax Number : 702-463-1851
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2010
Last Update Date : 07/16/2025

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Directions to “ MRS. SHARIE TYSETTE NELSON ” Practice Location

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