Provider Demographics
NPI:1396361689
Name:NEVADA FERTILITY CENTER
Entity Type:Organization
Organization Name:NEVADA FERTILITY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PYATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-892-9696
Mailing Address - Street 1:5320 S RAINBOW BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-1896
Mailing Address - Country:US
Mailing Address - Phone:702-892-9696
Mailing Address - Fax:702-892-9666
Practice Address - Street 1:5320 S RAINBOW BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-1896
Practice Address - Country:US
Practice Address - Phone:702-892-9696
Practice Address - Fax:702-892-9666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV7698Other1790734366