Organization
IDENTITY HORMONES NV LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA WILKINSON (BUSINESS OPERATIONS DIRECTOR)
(602) 796-2559
Entity
Organization
Contact information
Practice address
1701 N GREEN VALLEY PKWY STE F, HENDERSON, NV 89074-5885
(702) 661-3438
Mailing address
1701 N GREEN VALLEY PKWY STE F, HENDERSON, NV 89074-5885
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
Other
Enumeration date
03/04/2024
Last updated
02/19/2025
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