Individual
MULLISSA MICHELLE CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
222 S RAINBOW BLVD STE 115, LAS VEGAS, NV 89145-5343
(702) 406-4125
(702) 745-0452
Mailing address
5300 BRIGHT SUN CT, LAS VEGAS, NV 89130-3728
(614) 496-8420
(702) 745-0452
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
F0714788
OH
363LP2300X
Primary Care Nurse Practitioner
16446-NP
OH
363LP2300X
Primary Care Nurse Practitioner
Primary
APRN002193
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0113011
—
OH
05
—
0129662
—
OH
Enumeration date
08/09/2005
Last updated
08/21/2024
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