Individual
MRS. AMANDA MARIE THISTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2800 E DESERT INN RD STE 100, #100, LAS VEGAS, NV 89121-3609
(702) 731-1616
(702) 731-0741
Mailing address
2800 E DESERT INN RD STE 100, #100, LAS VEGAS, NV 89121-3609
(702) 731-1616
(702) 731-0741
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1293
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891076758
—
NV
Enumeration date
09/06/2011
Last updated
02/22/2017
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