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NPI Code Detail

MEDICARE: KYNAYDIA N NELSON

MEDICARE: KYNAYDIA N NELSON
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
1101YP2500XProfessional CounselorCI5164NV
2101YM0800XMental Health CounselorCI5164NV

General Provider Information

NPI Number : 1912354713
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYNAYDIA N NELSON
Provider Business Mailing Address
First Line : 5940 S RAINBOW BLVD STE 400
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-2507
Country : US
Telephone Number : 702-527-8032
Fax Number :
Provider Business Practice Location Address
First Line : 5940 S RAINBOW BLVD STE 400
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-2507
Country : US
Telephone Number : 702-527-8032
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2016
Last Update Date : 12/14/2023

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Directions to “ KYNAYDIA N NELSON ” Practice Location

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