MEDICARE: REBECCA S BRYANT LE

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	156F00000X	Technician/Technologist	E46	NV

General Provider Information

NPI Number	:	1902597164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA S BRYANT LE

Provider Business Mailing Address
First Line	:	501 S RANCHO DR STE H51
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4836
Country	:	US
Telephone Number	:	701-461-1879
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 S RANCHO DR STE H51
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4836
Country	:	US
Telephone Number	:	701-461-1879
Fax Number	:

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

Provider Enumeration Date	:	05/18/2023
Last Update Date	:	05/18/2023

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