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NPI Code Detail

MEDICARE: LEAH B HENRY APN

MEDICARE: LEAH B HENRY APN
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
1363LP2300XPrimary Care Nurse PractitionerAPN001230NV

General Provider Information

NPI Number : 1629372305
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEAH B HENRY APN
Provider Business Mailing Address
First Line : PO BOX 230181
Second Line :
City : LAS VEGAS
State : NV
Zip : 89105-0181
Country : US
Telephone Number : 702-837-1265
Fax Number : 702-837-1706
Provider Business Practice Location Address
First Line : 12300 LAS VEGAS BLVD S
Second Line :
City : HENDERSON
State : NV
Zip : 89044-9506
Country : US
Telephone Number : 702-837-1265
Fax Number : 702-837-1706
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2011
Last Update Date : 01/10/2011

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