Organization
FORMA INTEGRATED HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN UGANIZA (CEO)
(702) 531-4540
Entity
Organization
Contact information
Practice address
2655 S RAINBOW BLVD STE 410, LAS VEGAS, NV 89146-5100
(702) 726-9722
(702) 906-0067
Mailing address
2655 S RAINBOW BLVD STE 410, LAS VEGAS, NV 89146-5100
(702) 726-9722
(702) 906-0067
Taxonomy
Speciality
Code
Description
License number
State
103TF0000X
Family Psychologist
—
—
163WW0000X
Wound Care Registered Nurse
—
—
174400000X
Specialist
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
03/06/2026
Last updated
03/09/2026
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