MEDICARE: NEVADA HOLISTIC WELLNESS AND PSYCHIATRY CENTER, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1467147371
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEVADA HOLISTIC WELLNESS AND PSYCHIATRY CENTER, PLLC

Provider Business Mailing Address
First Line	:	1735 NAVARRE LN
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89014-3579
Country	:	US
Telephone Number	:	702-504-9935
Fax Number	:

Provider Business Practice Location Address
First Line	:	1735 NAVARRE LN
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89014-3579
Country	:	US
Telephone Number	:	702-504-9935
Fax Number	:

Authorized Official
Title or Position	:	NURSE PRACTIONER
Name	:	SHEENA MARIE SPANSKIE
Credential	:	APRN-PMHNP
Telephone Number	:	702-504-9935

Provider Enumeration Date	:	04/06/2023
Last Update Date	:	04/06/2023

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