MEDICARE: MR. MICHAEL A SCHRECKENGOST FNP-BC

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	363LF0000X	Family Nurse Practitioner	833286	NV

General Provider Information

NPI Number	:	1831733542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL A SCHRECKENGOST FNP-BC

Provider Business Mailing Address
First Line	:	2370 CORPORATE CIR STE 300
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-7760
Country	:	US
Telephone Number	:	702-910-3950
Fax Number	:

Provider Business Practice Location Address
First Line	:	880 SEVEN HILLS DR STE 140
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-4372
Country	:	US
Telephone Number	:	702-844-4840
Fax Number	:

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

Provider Enumeration Date	:	11/05/2019
Last Update Date	:	04/21/2023

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