# EDS-I HOMANSKY PRACTICES OF NEVADA PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720540628
- **Authorized official:** CHRISTOPHER KENNEDY (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (207) 807-9009

## Contact information

- **Practice address:** 360 S LOLA LN, PAHRUMP, NV 89048-0884
- **Practice address phone:** (954) 939-5000
- **Mailing address:** PO BOX 844322, LOS ANGELES, CA 90084-4322
- **Mailing address phone:** (954) 939-5000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/01/2019
- **Last updated:** 04/15/2026