Basic Information
| Provider Information | |||||||||
| NPI: | 1114398138 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ULEP-REED | ||||||||
| FirstName: | MAILEEN | ||||||||
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| Credential: | MSN, APRN, FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 888 W BONNEVILLE AVE | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891060100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7024836000 | ||||||||
| FaxNumber: | 7024836007 | ||||||||
| Practice Location | |||||||||
| Address1: | 888 W BONNEVILLE AVE | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891060100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7024836000 | ||||||||
| FaxNumber: | 7024836007 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2015 | ||||||||
| LastUpdateDate: | 04/01/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | APRN001970 | NV | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 1114398138 | 05 | NV | MEDICAID |