Healthcare Provider Details

I. General information

NPI: 1770233454
Provider Name (Legal Business Name): LINDSEY LEANN PHILLIPS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

283 N PECOS RD
HENDERSON NV
89074-1918
US

IV. Provider business mailing address

283 N PECOS RD
HENDERSON NV
89074-1918
US

V. Phone/Fax

Practice location:
  • Phone: 866-808-6005
  • Fax:
Mailing address:
  • Phone: 702-357-5814
  • Fax: 866-739-9251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number852803
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: