Individual
PIUS ATU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3455 W CRAIG RD STE C, NORTH LAS VEGAS, NV 89032-5119
(702) 625-0146
Mailing address
5205 WILD SUNFLOWER ST, NORTH LAS VEGAS, NV 89081-4037
(702) 625-0146
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
824610
NV
Other
Enumeration date
10/21/2019
Last updated
06/27/2025
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