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NPI Code Detail

MEDICARE: DR. KYLE PRATT NIELSON MD

MEDICARE: DR. KYLE PRATT NIELSON MD
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
12085R0202XDiagnostic Radiology Physician5547NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770583726
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KYLE PRATT NIELSON MD
Provider Business Mailing Address
First Line : 9790 BRIGHT ANGEL WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89149-1332
Country : US
Telephone Number : 702-235-4955
Fax Number :
Provider Business Practice Location Address
First Line : VA SOUTHERN NEVADA HEALTHCARE SYSTEM
Second Line : 6900 NORTH PECOS ROAD
City : NORTH LAS VEGAS
State : NV
Zip : 89086-4400
Country : US
Telephone Number : 702-799-9000
Fax Number : 702-224-6937
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2005
Last Update Date : 08/21/2023

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