| NPI | 1487231973 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JANEL IRENE HILLSTROM Nurse Practitioner 702-806-2954  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family | 
| Enumeration Date | 2021-03-29 | 
| Last Update Date | 2025-01-16 |