Provider Demographics
NPI:1477721223
Name:ADLER, MATYT L (NP)
Entity Type:Individual
Prefix:
First Name:MATYT
Middle Name:L
Last Name:ADLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3758 LAS VEGAS BLVD S
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-4132
Mailing Address - Country:US
Mailing Address - Phone:702-262-9028
Mailing Address - Fax:702-736-3921
Practice Address - Street 1:3758 LAS VEGAS BLVD S
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-4132
Practice Address - Country:US
Practice Address - Phone:702-262-9028
Practice Address - Fax:702-736-3921
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN001904363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily