Healthcare Provider Details

I. General information

NPI: 1831348234
Provider Name (Legal Business Name): JOANIE LEIGH GILLESPIE CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2008
Last Update Date: 09/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 COMMERCE CENTER DR SUITE A-10
HENDERSON NV
89014-2334
US

IV. Provider business mailing address

2 COMMERCE CENTER DR SUITE A-10
HENDERSON NV
89014-2334
US

V. Phone/Fax

Practice location:
  • Phone: 702-454-6078
  • Fax: 702-454-4024
Mailing address:
  • Phone: 702-454-6078
  • Fax: 702-454-4024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: