NPI 1669660221 · live from the CMS NPI Registry
Quanetta Linda Bazile, Physician Assistant
Physician Assistant in Las Vegas, NV. National Provider Identifier 1669660221, active.
NPI record
| NPI | 1669660221 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 3186 S Maryland Pkwy, Las Vegas, NV 89109 |
| Practice phone | 702-961-7310 |
| Enumerated | October 9, 2007 |
| Last updated | January 13, 2020 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | PA05764 (TX) |
| Physician Assistant | 363A00000X | 5601004715 (MI) |
| Physician Assistant primary | 363A00000X | PA1703 (NV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.