Individual
TAMIKA BOULWARE PHYFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
595 W LAKE MEAD PKWY, HENDERSON, NV 89015-7015
(702) 566-5500
(702) 558-7238
Mailing address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 216-3346
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
585
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750505095
—
NV
01
—
585
STATE LICENCE
NV
Enumeration date
04/11/2007
Last updated
10/19/2022
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