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NPI Code Detail

MEDICARE: MRS. AMANDA LYNN AYDIN FNP-C

MEDICARE: MRS. AMANDA LYNN AYDIN FNP-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
1363LF0000XFamily Nurse PractitionerNP 21710CA
2363LF0000XFamily Nurse PractitionerAPRN001782NV

General Provider Information

NPI Number : 1821363144
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMANDA LYNN AYDIN FNP-C
Provider Business Mailing Address
First Line : 10240 HUXLEY CROSS LN
Second Line :
City : LAS VEGAS
State : NV
Zip : 89144-1362
Country : US
Telephone Number : 702-475-2277
Fax Number :
Provider Business Practice Location Address
First Line : 10161 PARK RUN DR STE 150
Second Line :
City : LAS VEGAS
State : NV
Zip : 89145-8872
Country : US
Telephone Number : 702-707-3919
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2012
Last Update Date : 07/12/2019

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