Provider Demographics
NPI:1427151240
Name:BOARD OF REGENTS, NEVADA SYSTEM OF HIGHER EDUCATION
Entity type:Organization
Organization Name:BOARD OF REGENTS, NEVADA SYSTEM OF HIGHER EDUCATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL BUSINESS SVCS.
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:702-774-2819
Mailing Address - Street 1:1001 SHADOW LANE
Mailing Address - Street 2:MS 7413
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4124
Mailing Address - Country:US
Mailing Address - Phone:702-774-2400
Mailing Address - Fax:702-774-2499
Practice Address - Street 1:1700 W. CHARLESTON BLVD.
Practice Address - Street 2:BUILDING D
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2351
Practice Address - Country:US
Practice Address - Phone:702-774-8000
Practice Address - Fax:702-774-2499
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOARD OF REGENTS, NV SYSTEM OF HIGHER EDUCATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-07
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4293261QD0000X
261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental