Organization
JOHN PHOENIX APRN PLLC
Active
Other names
Huntridge Family Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN R PHOENIX APRN (OWNER)
(702) 523-9025
Entity
Organization
Contact information
Practice address
2000 S EASTERN AVE STE R, LAS VEGAS, NV 89104-4100
(702) 523-9025
(775) 310-9190
Mailing address
1909 COCHRAN ST, LAS VEGAS, NV 89104-3538
(702) 523-9025
(775) 310-9190
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN001359
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100534176
—
NV
Enumeration date
08/28/2013
Last updated
08/03/2024
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