Individual
WALLY JOSEPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-C, PMHNP-BC
Contact information
Practice address
600 W SUNSET RD STE 102, HENDERSON, NV 89011-4112
(725) 241-5252
Mailing address
600 W SUNSET RD STE 102, HENDERSON, NV 89011-4112
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
836179
NV
363LF0000X
Family Nurse Practitioner
Primary
95004317
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
836179
NV
Other
Enumeration date
09/08/2016
Last updated
08/21/2023
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