Provider Demographics
NPI:1811308604
Name:BELLER, PEGGY LYNN (NP)
Entity type:Individual
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First Name:PEGGY
Middle Name:LYNN
Last Name:BELLER
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Gender:F
Credentials:NP
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Mailing Address - Street 1:3012 S DURANGO DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-9186
Mailing Address - Country:US
Mailing Address - Phone:702-366-1655
Mailing Address - Fax:702-942-4388
Practice Address - Street 1:5380 S RAINBOW BLVD
Practice Address - Street 2:STE. 120
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-1877
Practice Address - Country:US
Practice Address - Phone:702-233-3444
Practice Address - Fax:702-233-6998
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2019-08-02
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Provider Licenses
StateLicense IDTaxonomies
NV000000363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner