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Contact Information

KIM G MOFFATT BAZILE, PNP
3121 S. MARYLAND PKWY
SUITE 220
LAS VEGAS, NV89109
 Phone: 702-732-1493
 Fax: 702-732-1080
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Pediatrics

163WP0200X
Indicates primary specialty

NPI Profile & details for KIM G MOFFATT BAZILE · (Female)

NPI Number 1619003928
Status Active
Credentials PNP
Entity Individual
Enumeration date 02/23/2007
Last updated 05/16/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • CA License # 8485
  • NV License # APRN001811
  • NV License # RN80724
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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