MEDICARE: PURE LIFE 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	251S00000X	Community/Behavioral Health Agency	NV20181591545	NV

General Provider Information

NPI Number	:	1790265544
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PURE LIFE LLC

Provider Business Mailing Address
First Line	:	2513 BRAVE HEART AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-0685
Country	:	US
Telephone Number	:	951-667-5754
Fax Number	:

Provider Business Practice Location Address
First Line	:	2513 BRAVE HEART AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-0685
Country	:	US
Telephone Number	:	951-667-5754
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KARLONDRA WILLIAMS
Credential	:
Telephone Number	:	773-701-3956

Provider Enumeration Date	:	08/20/2018
Last Update Date	:	08/20/2018

Similar Medicare Providers

1205079118 — FAMILY IMPACT OF NEVADA
Practice Location Address:

2513 BRAVE HEART AVE
N LAS VEGAS, NV
89031-0685

Practice Phone: 702-883-9750
Practice Fax:

1679421945 — COMPASSIONATE CARE MEDICAL CENTER LLC
Practice Location Address:

408 VILLA ESPANA WAY
NORTH LAS VEGAS, NV
89031-2805

Practice Phone: 725-888-3000
Practice Fax:

1922947290 — CYNTHIA IRIS LOFQUIST
Practice Location Address:

1236 STONESTHROW CIR
NORTH LAS VEGAS, NV
89031-2356

Practice Phone: 702-715-6808
Practice Fax:

1013856269 — QANDEEL FATIMAH CHEVALWALA RBT
Practice Location Address:

5441 MAGIC MANGO ST
NORTH LAS VEGAS, NV
89031-7845

Practice Phone: 703-485-5511
Practice Fax:

1023965373 — CERA PAIGE LOPEZ NITAFAN
Practice Location Address:

2425 WINDY HILLS AVE
NORTH LAS VEGAS, NV
89031-4358

Practice Phone: 702-201-9678
Practice Fax:

1134877756 — MS. MARICRIS LORRAINE MARZO MSN, APRN, FNP-BC
Practice Location Address:

4755 W ANN RD
NORTH LAS VEGAS, NV
89031-3424

Practice Phone: 702-407-7063
Practice Fax:

Directions to “PURE LIFE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.