Organization · NPI-2

702 Family Practice LLC

Nurse Practitioner, Family · Las Vegas, NV

NPI number1548085491
StatusActive
Last updated in NPPESNov 18, 2024

Details

NPI
1548085491
Entity type
Organization (NPI-2)
Legal business name
702 Family Practice LLC
Organization subpart
No
Enumeration date
Nov 16, 2024
Certification date
Nov 18, 2024
Last updated
Nov 18, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family––Yes

Practice location

3468 E Sahara Ave Ste 160
Las Vegas, NV 89104-4827

Phone 702-389-5700

Mailing address

3468 E Sahara Ave Ste 160
Las Vegas, NV 89104-4827

Phone 702-389-5700

Authorized official

Iredila Timagos Bynum
Owner
7023895700

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