MEDICARE: NNP SERVICES PROFESSIONAL LLC

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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1730041617
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NNP SERVICES PROFESSIONAL LLC

Provider Business Mailing Address
First Line	:	1232 ALFORD CREEK CT
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-0788
Country	:	US
Telephone Number	:	702-816-0409
Fax Number	:

Provider Business Practice Location Address
First Line	:	1232 ALFORD CREEK CT
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-0788
Country	:	US
Telephone Number	:	702-816-0409
Fax Number	:

Authorized Official
Title or Position	:	HEALTHCARE PROVIDER/MANAGER/MEMBER
Name	:	DR. NICHOLAS NALIC PIERIDES JR.
Credential	:	OTD, OTR/L
Telephone Number	:	702-816-0409

Provider Enumeration Date	:	11/28/2025
Last Update Date	:	11/28/2025

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