IndividualActive
Brooke Wagner
NPI 1396574273 · Licensed Practical Nurse · Las Vegas, NV
Provider details
- NPI number
- 1396574273
- Entity type
- Individual
- Primary specialty
- Licensed Practical NurseNursing Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 853791 (NV)
Specialties & taxonomies
Nursing Service Providers
Practice location
4040 S Eastern Ave Ste 300
Las Vegas, NV 89119-0854
Phone: (702) 463-0300
Fax: (702) 460-0301
Approximate (ZIP-level) locationGet directions
Mailing address
4040 S Eastern Ave Ste 300
Las Vegas, NV 89119-0854
Registry dates
- Enumerated
- 2024-07-30
- Last updated
- 2024-07-30
- Certified
- 2024-07-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.