Individual
DYLAN MCNICOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3150 N TENAYA WAY STE 260, LAS VEGAS, NV 89128-0459
(702) 962-5920
Mailing address
PO BOX 100744, ATLANTA, GA 30384-0744
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
860851
NV
Other
Enumeration date
08/12/2021
Last updated
06/14/2023
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