MEDICARE: BRITTNY CALL AHRENDES PA-C

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	363A00000X	Physician Assistant	53417	CA
2	207NS0135X	Procedural Dermatology Physician	PA1363	NV
3	363A00000X	Physician Assistant	1363	NV

General Provider Information

NPI Number	:	1689846826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTNY CALL AHRENDES PA-C

Provider Business Mailing Address
First Line	:	2285 CORPORATE CIR
Second Line	:	STE 200
City	:	HENDERSON
State	:	NV
Zip	:	89074-7759
Country	:	US
Telephone Number	:	702-360-2763
Fax Number	:	949-783-2880

Provider Business Practice Location Address
First Line	:	1250 S BUFFALO DR STE 170
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-8329
Country	:	US
Telephone Number	:	702-255-7924
Fax Number	:	702-242-9949

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

Provider Enumeration Date	:	03/27/2008
Last Update Date	:	03/26/2019

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