Provider Demographics
NPI:1730690496
Name:EWING, RANDI LYNN GEHRMAN (APRN, AGNP-C)
Entity type:Individual
Prefix:MRS
First Name:RANDI
Middle Name:LYNN GEHRMAN
Last Name:EWING
Suffix:
Gender:F
Credentials:APRN, AGNP-C
Other - Prefix:
Other - First Name:RANDI
Other - Middle Name:LYNN
Other - Last Name:GEHRMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4141 SWENSON ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6718
Mailing Address - Country:US
Mailing Address - Phone:715-607-0847
Mailing Address - Fax:
Practice Address - Street 1:6655 W SAHARA AVE STE B114
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-0844
Practice Address - Country:US
Practice Address - Phone:702-489-4412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-19
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN002686363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner