Individual
JANICE BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
888 S RANCHO DR, LAS VEGAS, NV 89106-3810
(702) 877-5199
Mailing address
888 S RANCHO DR, LAS VEGAS, NV 89106-3810
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2547
NV
Other
Enumeration date
09/20/2019
Last updated
03/12/2023
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