| NPI | 1609327931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN B ANDRACKI Clinical Director 702-333-0110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2016-10-21 |
| Last Update Date | 2024-05-11 |