Healthcare Provider Details

I. General information

NPI: 1104760834
Provider Name (Legal Business Name): LIGGONS & CLARK HEALTHCARE GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 W OWENS AVE STE 150
LAS VEGAS NV
89106-2583
US

IV. Provider business mailing address

PO BOX 43527
BELFAST ME
04915-1287
US

V. Phone/Fax

Practice location:
  • Phone: 702-600-7358
  • Fax:
Mailing address:
  • Phone: 702-289-4627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DAWN CLARK
Title or Position: MANAGING MEMBER/FNP
Credential: FNP
Phone: 702-600-7358