MEDICARE: TIAE PARKER-YOUNG

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	163W00000X	Registered Nurse	RN37964	NV

General Provider Information

NPI Number	:	1922427293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIAE PARKER-YOUNG

Provider Business Mailing Address
First Line	:	1224 BARTON GREEN DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1680
Country	:	US
Telephone Number	:	702-541-4167
Fax Number	:

Provider Business Practice Location Address
First Line	:	1224 BARTON GREEN DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1680
Country	:	US
Telephone Number	:	702-541-4167
Fax Number	:

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

Provider Enumeration Date	:	04/15/2014
Last Update Date	:	04/15/2014

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Directions to “ TIAE PARKER-YOUNG ” Practice Location

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