| NPI | 1700360534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALIKA COPPEDGE Owner 702-434-5114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2018-09-18 |