Provider Demographics
NPI:1093271132
Name:REYES, EVELYN (FNP)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:REYES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 E RUSSELL RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3802
Mailing Address - Country:US
Mailing Address - Phone:702-780-1313
Mailing Address - Fax:702-476-9073
Practice Address - Street 1:4020 E RUSSELL RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3802
Practice Address - Country:US
Practice Address - Phone:702-780-1313
Practice Address - Fax:702-476-9073
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-13
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV817579363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily