Home Professional Nurse Practitioner LLC
Nurse Practitioner, Primary Care in Las Vegas, NV. Organization (NPI-2).
NPI number1669944484
StatusActive
Last updated in NPPESDec 18, 2018
Details
- NPI
- 1669944484
- Entity type
- Organization (NPI-2)
- Legal business name
- Home Professional Nurse Practitioner LLC
- Organization subpart
- No
- Enumeration date
- Dec 18, 2018
- Last updated
- Dec 18, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP2300X | Nurse Practitioner, Primary Care | – | – | Yes |
Practice location
3017 W Charleston Blvd Ste 70Las Vegas, NV 89102-1928
Phone 702-913-9380
Mailing address
3017 W Charleston Blvd Ste 70Las Vegas, NV 89102-1928
Phone 702-913-9380
Authorized official
Mae Derequito Lueck
Ceo
7029139380
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