Individual
SUSAN L MAGADAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8285 W ARBY AVE STE 100B, LAS VEGAS, NV 89113-2235
(702) 735-7154
(702) 405-1860
Mailing address
PO BOX 98978, LAS VEGAS, NV 89193-8978
(702) 216-3346
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
4103
WI
363A00000X
Physician Assistant
5548
AZ
363A00000X
Physician Assistant
PA03559
TX
363L00000X
Nurse Practitioner
Primary
PA1953
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508929969
—
NV
05
—
199127501
—
TX
05
—
901489
—
AZ
01
—
PA1953
STATE LICENSE
NV
Enumeration date
12/18/2006
Last updated
04/23/2018
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