Organization
PRIMARY WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM QUIBA NP (MANAGER)
(702) 576-6102
Entity
Organization
Contact information
Practice address
5120 S PECOS RD, LAS VEGAS, NV 89120-1237
(702) 576-6102
(725) 224-0909
Mailing address
6720 N HUALAPAI WAY STE 145, BOX 12, LAS VEGAS, NV 89149
(702) 576-6102
(725) 224-0909
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/03/2023
Last updated
11/29/2023
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