NPI | 1073033528 |
---|---|
Doing Business As | CCM MEDICAL SERVICES |
Entity Type | Organization |
Authorized Contact | MULLISSA MICHELLE CHILDRESS Nurse Practitioner Provider 702-406-4125 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine |
208D00000X General Practice | |
Enumeration Date | 2017-06-26 |
Last Update Date | 2024-08-21 |