Healthcare Provider Details

I. General information

NPI: 1083981955
Provider Name (Legal Business Name): STEFANIE D REMSON APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2011
Last Update Date: 04/13/2020
Certification Date: 04/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N GIBSON RD STE 201
HENDERSON NV
89011-1706
US

IV. Provider business mailing address

2200 PASEO VERDE PKWY STE 260
HENDERSON NV
89052-2703
US

V. Phone/Fax

Practice location:
  • Phone: 702-616-5801
  • Fax:
Mailing address:
  • Phone: 702-616-7660
  • Fax: 702-616-7713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN001333
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: