Provider Demographics
NPI:1871281535
Name:SY, PAULA (AGACNP-BC)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:SY
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1089 VIA DELLA COSTRELLA
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89011-0955
Mailing Address - Country:US
Mailing Address - Phone:702-215-1957
Mailing Address - Fax:
Practice Address - Street 1:825 N GIBSON RD STE 201
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89011-1708
Practice Address - Country:US
Practice Address - Phone:702-492-1162
Practice Address - Fax:702-563-3380
Is Sole Proprietor?:No
Enumeration Date:2023-04-28
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV866839363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care