Individual
AMITY ELISE HERRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
4488 S PECOS RD, LAS VEGAS, NV 89121-5030
(702) 436-1001
(702) 436-7999
Mailing address
101 E REDLANDS BLVD, SUITE 212, REDLANDS, CA 92373-4775
(909) 335-7649
(909) 557-1953
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA905
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA905
P.A. LICENSE
NV
Enumeration date
03/02/2009
Last updated
06/24/2010
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