Organization
HEALTHY LIFELINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MARIUS TOLENTINO APRN (MANAGING MEMBER)
(702) 445-4092
Entity
Organization
Contact information
Practice address
3557 WINTER WREN ST, LAS VEGAS, NV 89122-3539
(702) 782-7828
Mailing address
3557 WINTER WREN ST, LAS VEGAS, NV 89122-3539
(702) 782-7828
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
261QP2300X
Primary Care Clinic/Center
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/01/2025
Last updated
04/01/2025
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