| NPI | 1003617242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA MONTECILLO CEO 702-826-0956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WW0000X Registered Nurse, Wound Care |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2025-03-24 |
| Last Update Date | 2025-04-02 |