Individual
SHANE A DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
8680 W CHEYENNE AVE, LAS VEGAS, NV 89129-7458
(702) 877-5199
Mailing address
PO BOX 98978, LAS VEGAS, NV 89193-8978
(702) 216-3346
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN002474
NV
363LF0000X
Family Nurse Practitioner
APRN002474
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194264689
—
NV
Enumeration date
02/16/2017
Last updated
01/26/2026
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