| NPI | 1841929536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIA VIDEVA Provider 702-406-5906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2025-11-18 |