Healthcare Provider Details

I. General information

NPI: 1104051432
Provider Name (Legal Business Name): HEALTH TECHNOLOGY SERVICE SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2009
Last Update Date: 05/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1090 WIGWAM PKWY SUITE 100
HENDERSON NV
89074-8181
US

IV. Provider business mailing address

1090 WIGWAM PKWY SUITE 100
HENDERSON NV
89074-8181
US

V. Phone/Fax

Practice location:
  • Phone: 702-454-0201
  • Fax: 702-454-1245
Mailing address:
  • Phone: 702-454-0201
  • Fax: 702-454-1245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024164480
License Number StateVA

VIII. Authorized Official

Name: DENISE DAY CROSSON
Title or Position: OWNER
Credential: FNP,PH.D.
Phone: 702-454-0201