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Individual

MR. KEVIN ROA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PMHNP

Contact information

Practice address
620 S TONOPAH DR, LAS VEGAS, NV 89106-4029
(702) 413-1391
(702) 413-1392
Mailing address
2775 S JONES BLVD STE 101, LAS VEGAS, NV 89146-5632
(702) 685-3300

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
857971
NV
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
857971
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1760195796
NV
Enumeration date
09/09/2022
Last updated
06/07/2023
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