Provider Demographics
NPI:1417338864
Name:SELLARS, LAYNE (RN)
Entity Type:Individual
Prefix:
First Name:LAYNE
Middle Name:
Last Name:SELLARS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2975 S RAINBOW BLVD
Mailing Address - Street 2:STE E
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-6242
Mailing Address - Country:US
Mailing Address - Phone:702-227-0353
Mailing Address - Fax:702-368-7598
Practice Address - Street 1:2975 S RAINBOW BLVD
Practice Address - Street 2:STE E
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-6242
Practice Address - Country:US
Practice Address - Phone:702-227-0353
Practice Address - Fax:702-368-7598
Is Sole Proprietor?:No
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN82669163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse