Stephanie Lynn Atiyeh, PA-C

Individual provider Active NPI Physician Assistant · Las Vegas, NV

NPI 1487199501 · NPPES record last updated Apr 22, 2019

Key facts

NPI
1487199501
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
PA1805 (NV)
Practice address
653 N Town Center Dr Ste 512
Las Vegas, NV 89144-0519
Phone
(702) 796-7546
Fax
(702) 255-3223
NPI assigned
Dec 28, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA1805NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Dermatology LLC Past Accepting new patients
Stephen William Doggett, M.D. PA Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1805 NV Yes

Addresses

Primary practice location

653 N Town Center Dr Ste 512
Las Vegas, NV 89144-0519

Mailing address

653 N Town Center Dr Ste 512
Las Vegas, NV 89144-0519
Phone (702) 796-7546

Other providers in Las Vegas, NV

All providers in Las Vegas, NV · Physician Assistant in Nevada

Sources for this page

Verify at the official NPI Registry.