Healthcare Provider Details

I. General information

NPI: 1366008120
Provider Name (Legal Business Name): AMY MARIE FALCONE-WHARTON MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2019
Last Update Date: 05/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 N GREEN VALLEY PKWY BLDG 3 STE B
HENDERSON NV
89074-5885
US

IV. Provider business mailing address

1701 N GREEN VALLEY PKWY BLDG 3 STE B
HENDERSON NV
89074-5885
US

V. Phone/Fax

Practice location:
  • Phone: 702-737-3200
  • Fax: 702-369-4727
Mailing address:
  • Phone: 702-737-3200
  • Fax: 702-369-4727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: TERESA BRANSON
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 702-712-4869