Healthcare Provider Details

I. General information

NPI: 1073397592
Provider Name (Legal Business Name): THOMAS CHRISTOPHER MCNEIL APRN-CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2023
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4791 E PALM CANYON DR STE 100
PALM SPRINGS CA
92264-5232
US

IV. Provider business mailing address

401 S MARYLAND PKWY
LAS VEGAS NV
89101-7206
US

V. Phone/Fax

Practice location:
  • Phone: 760-834-7390
  • Fax: 760-834-7931
Mailing address:
  • Phone: 702-773-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number95039592
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number845496
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: