MEDICARE: REMY PREMIER HEALTH SERVICES

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	:	1952867749
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REMY PREMIER HEALTH SERVICES

Provider Business Mailing Address
First Line	:	3450 W CHEYENNE AVE STE 200
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89032-8223
Country	:	US
Telephone Number	:	702-451-0172
Fax Number	:	702-451-0173

Provider Business Practice Location Address
First Line	:	3450 W CHEYENNE AVE STE 200
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89032-8223
Country	:	US
Telephone Number	:	702-451-0172
Fax Number	:	702-451-0173

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	MRS. TIANA HUBBARD
Credential	:	APN
Telephone Number	:	314-406-9081

Provider Enumeration Date	:	02/16/2019
Last Update Date	:	09/11/2025

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