MEDICARE: MS. EVERLENE MCALLISTER CPT

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	246RP1900X	Phlebotomy Technician

General Provider Information

NPI Number	:	1689408577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EVERLENE MCALLISTER CPT

Provider Business Mailing Address
First Line	:	7121 W CRAIG RD # 113-211
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-6001
Country	:	US
Telephone Number	:	725-242-3354
Fax Number	:

Provider Business Practice Location Address
First Line	:	7121 W CRAIG RD # 113-211
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-6001
Country	:	US
Telephone Number	:	725-242-3354
Fax Number	:

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

Provider Enumeration Date	:	08/31/2024
Last Update Date	:	08/31/2024

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