Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Derek Beau Bouvier

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1649962689

Derek Beau Bouvier is a Student in an Organized Health Care Education/Training Program in Las Vegas, Nevada. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

1001 Shadow Ln
Las Vegas, NV 89106-4124
Phone: (702) 774-2545
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1649962689
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 25, 2023
Last updated in NPPESMay 25, 2023
Certification dateMay 25, 2023
Mailing address1001 Shadow Ln, Las Vegas, NV 89106-4124

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