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Organization

REVOLUTION HEALTH LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATIE BASS APRN (OWNER)
(702) 703-1202
Entity
Organization

Contact information

Practice address
6301 MOUNTAIN VISTA ST STE 209, HENDERSON, NV 89014-2364
(702) 703-1202
Mailing address
6301 MOUNTAIN VISTA ST STE 209, HENDERSON, NV 89014-2364
(702) 703-1202

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
250011291
NV
Enumeration date
08/04/2021
Last updated
04/18/2022
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