Individual
MS. SHERRY R. HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2800 E DESERT INN RD STE 100, LAS VEGAS, NV 89121-3609
(702) 731-1616
(702) 734-4900
Mailing address
2800 E DESERT INN RD STE 100, LAS VEGAS, NV 89121-3609
(702) 731-1616
(702) 734-4900
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
0010-03118
NC
363AS0400X
Surgical Physician Assistant
007274
GA
363AS0400X
Surgical Physician Assistant
50.001903
OH
363AS0400X
Surgical Physician Assistant
Primary
PA1786
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003150687
—
GA
05
—
1245203397
—
NV
05
—
164750
—
AL
01
—
20297I6311
MEDICARE PTAN
GA
Enumeration date
02/09/2006
Last updated
08/28/2020
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