Festus Ebonka
Nurse Practitioner, Psych/Mental Health in Las Vegas, NV. Individual provider (NPI-1).
NPI number1932241007
StatusActive
Last updated in NPPESJan 21, 2025
Details
- NPI
- 1932241007
- Entity type
- Individual (NPI-1)
- Name
- Festus Ebonka
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 13, 2007
- Certification date
- Jan 21, 2025
- Last updated
- Jan 21, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | APRN000902 | NV | Yes |
| 363LF0000X | Nurse Practitioner, Family | APrN000902 | NV |
Practice location
1721 E Charleston BlvdLas Vegas, NV 89104-1902
Phone 702-515-9680 · Fax 702-685-9674
Mailing address
1721 E. Charleston Blvd.Las Vegas, NV 89104-1902
Phone 702-515-9680 · Fax 702-685-9674
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