| NPI | 1912599168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES RUSSELL Manager 702-787-9637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| 208VP0000X Pain Medicine, Pain Medicine | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| 363L00000X Nurse Practitioner | |
| 363LA2100X Nurse Practitioner, Acute Care | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LC0200X Nurse Practitioner, Critical Care Medicine | |
| 363LC1500X Nurse Practitioner, Community Health | |
| Enumeration Date | 2021-02-09 |
| Last Update Date | 2022-10-28 |