Individual
FARA TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7751 W FLAMINGO RD, A 100, LAS VEGAS, NV 89147-4399
(702) 804-1212
(702) 804-1222
Mailing address
7751 W FLAMINGO RD, A 100, LAS VEGAS, NV 89147-4399
(702) 804-1212
(702) 804-1222
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN001912
NV
Other
Enumeration date
06/12/2015
Last updated
06/12/2015
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