Individual ProviderFangyan PanTechnicianNursing Service Related ProvidersPractice Address2770 S Maryland Pkwy Ste 108b-G, Las Vegas, NV 89109-1554(702) 463-7779(725) 300-4336PECOS EnrollmentBased on the most recent information from CMS, provider Fangyan Pan does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1346895786Provider TypeIndividualFull NamePan, FangyanGenderFemaleSole ProprietorYesEnumeration Date8/2/2019Last Updated9/3/2019Contact InformationPractice LocationPractice Address2770 S Maryland Pkwy Ste 108b-G, Las Vegas, NV 89109-1554Phone(702) 463-7779FaxUnlisted FaxMailing LocationMailing Address2901 S Highland Dr, Las Vegas, NV 89109-1081Phone(725) 300-4336FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode3747P1801XPrimaryDescriptionTechnicianNursing Service Related ProvidersLicenseUnlisted Issuer