Tanner Croshaw, PA
in North Las Vegas, NV. Individual provider (NPI-1).
NPI number1306424692
StatusActive
Last updated in NPPESMar 30, 2021
Details
- NPI
- 1306424692
- Entity type
- Individual (NPI-1)
- Name
- Tanner Croshaw
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 30, 2021
- Certification date
- Mar 30, 2021
- Last updated
- Mar 30, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208VP0000X | 1179657 | NV | Yes |
Practice location
3970 W Ann Rd Ste 100North Las Vegas, NV 89031-3853
Phone 702-747-4799 · Fax 702-747-4667
Mailing address
3970 W Ann Rd Ste 100North Las Vegas, NV 89031-3853
Phone 702-747-4799 · Fax 702-747-4667
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