Healthcare Provider Details

I. General information

NPI: 1609596485
Provider Name (Legal Business Name): RUNE ENSINGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RUNE ENSINGER

II. Dates (important events)

Enumeration Date: 08/31/2022
Last Update Date: 05/25/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8685 S EASTERN AVE
LAS VEGAS NV
89123-2839
US

IV. Provider business mailing address

8685 S EASTERN AVE
LAS VEGAS NV
89123-2839
US

V. Phone/Fax

Practice location:
  • Phone: 702-754-0807
  • Fax:
Mailing address:
  • Phone: 702-378-8924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: