Organization
EMPOWERED PAIN PRIMARY AND URGENT CARE CENTER OF NEVADA LLC
Active
Organization
EMPOWERED PAIN PRIMARY AND URGENT CARE CENTER OF NEVADA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES RUSSELL (MANAGER)
(702) 787-9637
Entity
Organization
Contact information
Practice address
6465 W SAHARA AVE STE 103, LAS VEGAS, NV 89146-3071
(702) 822-1881
(702) 822-1880
Mailing address
6465 W SAHARA AVE STE 103, LAS VEGAS, NV 89146-3071
(702) 822-1881
(702) 822-1880
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LC0200X
Critical Care Medicine Nurse Practitioner
—
—
363LC1500X
Community Health Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250018412
—
NV
01
—
B202102081415526
NEVADA SECRETARY OF STATE
NV
Enumeration date
02/09/2021
Last updated
10/28/2022
Update your record
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