Provider Demographics
NPI:1518917111
Name:MICHLIN, LAURIE (APN)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:MICHLIN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2540 W HORIZON RIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-5616
Mailing Address - Country:US
Mailing Address - Phone:702-385-7001
Mailing Address - Fax:702-385-7002
Practice Address - Street 1:2540 W HORIZON RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-5616
Practice Address - Country:US
Practice Address - Phone:702-385-7001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA1894363A00000X
NVAPN000723363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100502667Medicaid
NV100502667Medicaid
NVQ10320Medicare UPIN