Individual
NANA ERICSSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3540 W SAHARA AVE, 330, LAS VEGAS, NV 89102-5816
(702) 921-6823
(702) 921-6821
Mailing address
2600 S RAINBOW BLVD, 108, LAS VEGAS, NV 89146-4006
(702) 921-6823
(702) 921-6821
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
11476
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100507057
—
NV
Enumeration date
05/03/2006
Last updated
02/15/2011
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