Organization
MULLISSA CHILDRESS CCM MEDICAL SERVICES
Active
Other names
CCM Medical Services
Organization subpart
No
Provider details
NPI number
Authorized official
MULLISSA MICHELLE CHILDRESS APRN (NURSE PRACTITIONER PROVIDER)
(702) 406-4125
Entity
Organization
Contact information
Practice address
222 S RAINBOW BLVD STE 115, LAS VEGAS, NV 89145-5126
(702) 406-4125
Mailing address
5300 BRIGHT SUN CT, LAS VEGAS, NV 89130
(614) 496-8420
(702) 745-0452
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
—
—
208D00000X
General Practice Physician
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/26/2017
Last updated
04/10/2025
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