Individual
KORTNEY MORTIMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2316 W CHARLESTON BLVD, LAS VEGAS, NV 89102-2149
(702) 877-8330
(702) 877-8312
Mailing address
PO BOX 15645, LAS VEGAS, NV 89114-5645
(702) 877-8330
(702) 877-8312
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1339
NV
363AM0700X
Medical Physician Assistant
PA1339
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467638809
—
NV
Enumeration date
01/16/2008
Last updated
03/24/2023
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