Individual
KYLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2212 S EASTERN AVE, LAS VEGAS, NV 89104-4124
(702) 735-9334
(702) 735-9335
Mailing address
3325 RESEARCH WAY, CARSON CITY, NV 89706-7913
(775) 888-6610
(775) 888-4904
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
54967
CA
363A00000X
Physician Assistant
Primary
PA1444
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326480229
—
NV
01
—
PA1444
NV PA LICENSE
NV
01
—
V111642
SMA MEDICARE
NV
Enumeration date
07/22/2013
Last updated
12/09/2025
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