Basic Information
Provider Information
NPI: 1053872119
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BEST
FirstName: MELISSA
MiddleName: POK
NamePrefix:  
NameSuffix:  
Credential: FNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1800 W. CHARLESTON BLVD. STE. 508
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 891021125
CountryCode: US
TelephoneNumber: 7023832688
FaxNumber:  
Practice Location
Address1: 9320 W. SAHARA AVE.
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 89117
CountryCode: US
TelephoneNumber: 7023832633
FaxNumber: 7025622810
Other Information
ProviderEnumerationDate: 03/29/2019
LastUpdateDate: 09/06/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X819786NVY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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