Provider Demographics
NPI:1184197972
Name:DEMETER, EVA (PA-C)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:DEMETER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4760 BLUE DIAMOND RD.
Mailing Address - Street 2:STE. 110
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139
Mailing Address - Country:US
Mailing Address - Phone:702-838-2300
Mailing Address - Fax:702-678-1886
Practice Address - Street 1:4760 BLUE DIAMOND RD.
Practice Address - Street 2:STE. 110
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89139
Practice Address - Country:US
Practice Address - Phone:702-838-2300
Practice Address - Fax:702-678-1886
Is Sole Proprietor?:No
Enumeration Date:2019-01-04
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA2091363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant