| NPI | 1518653450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE WALKER Manager 702-580-7997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 163WW0000X Registered Nurse Wound Care |
| 246XC2903X Specialist/Technologist Cardiovascular Vascular Specialist | |
| 363LP2300X Nurse Practitioner Primary Care | |
| Enumeration Date | 2023-04-13 |
| Last Update Date | 2023-04-13 |