MEDICARE: REBECCA ANN REILLY

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	207Q00000X	Family Medicine Physician	839946	NV

General Provider Information

NPI Number	:	1952983009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA ANN REILLY

Provider Business Mailing Address
First Line	:	2801 N TENAYA WAY STE B-C
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1419
Country	:	US
Telephone Number	:	702-684-7800
Fax Number	:	702-684-7878

Provider Business Practice Location Address
First Line	:	2801 N TENAYA WAY STE B-C
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1419
Country	:	US
Telephone Number	:	702-684-7800
Fax Number	:	702-684-7878

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

Provider Enumeration Date	:	04/27/2021
Last Update Date	:	04/27/2021

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Directions to “ REBECCA ANN REILLY ” Practice Location

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