MEDICARE: MERRALL EVANS

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	374J00000X	Doula

General Provider Information

NPI Number	:	1780404343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERRALL EVANS

Provider Business Mailing Address
First Line	:	6537 HARTWOOD RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-4404
Country	:	US
Telephone Number	:	909-838-0626
Fax Number	:

Provider Business Practice Location Address
First Line	:	6537 HARTWOOD RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-4404
Country	:	US
Telephone Number	:	909-838-0626
Fax Number	:

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

Provider Enumeration Date	:	10/16/2024
Last Update Date	:	10/16/2024

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Directions to “ MERRALL EVANS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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