IndividualActive
Kelly Van Wagner, M.D.
NPI 1306035571 · Internal Medicine Physician · N. Las Vegas, NV
Provider details
- NPI number
- 1306035571
- Entity type
- Individual
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- Yes
- License
- 9533 (NV)
Practice location
6380 N. Decatur Blvd
Ste 215
N. Las Vegas, NV 89084
Phone: (702) 948-1145
Fax: (702) 949-6206
Mailing address
6355 S Buffalo Dr Fl 3
Las Vegas, NV 89113-2133
Registry dates
- Enumerated
- 2007-10-23
- Last updated
- 2023-02-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.