MEDICARE: KRISTEN LAYMON

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	225400000X	Rehabilitation Practitioner
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	20542	NV

General Provider Information

NPI Number	:	1952761009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN LAYMON

Provider Business Mailing Address
First Line	:	8985 S DURANGO DR UNIT 1083
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-6122
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3850 E FLAMINGO RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-6227
Country	:	US
Telephone Number	:	720-451-5536
Fax Number	:

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

Provider Enumeration Date	:	03/02/2016
Last Update Date	:	07/06/2020

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Directions to “ KRISTEN LAYMON ” Practice Location

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