Healthcare Provider Details

I. General information

NPI: 1720358039
Provider Name (Legal Business Name): DIGNITY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2012
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N GIBSON RD STE 101
HENDERSON NV
89011
US

IV. Provider business mailing address

3001 SAINT ROSE PKWY
HENDERSON NV
89052-3839
US

V. Phone/Fax

Practice location:
  • Phone: 702-616-5865
  • Fax:
Mailing address:
  • Phone: 702-616-6580
  • Fax: 702-616-6584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MELISSA WALKER
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 702-616-5507