Individual
PAULINE MARIE HEUSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4475 S EASTERN AVE, LAS VEGAS, NV 89119
(702) 877-5199
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 877-5199
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0385
NV
363A00000X
Physician Assistant
PA1521
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134548456
SMA MEDICAID
NV
Enumeration date
04/15/2014
Last updated
10/26/2021
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