MEDICARE: NOMAD WHOLE WELLNESS 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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1922941970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOMAD WHOLE WELLNESS LLC

Provider Business Mailing Address
First Line	:	98 E LAKE MEAD PKWY STE 105
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89015-6443
Country	:	US
Telephone Number	:	253-376-4234
Fax Number	:

Provider Business Practice Location Address
First Line	:	98 E LAKE MEAD PKWY STE 105
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89015-6443
Country	:	US
Telephone Number	:	253-376-4234
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. RONALD DECAMP II
Credential	:
Telephone Number	:	253-376-4234

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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