Healthcare Provider Details

I. General information

NPI: 1902234156
Provider Name (Legal Business Name): NADINE ELAINE WRIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2013
Last Update Date: 10/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4425 SOUTH JONES BLVD SUITE D3
LAS VEGA NV
89103
US

IV. Provider business mailing address

4425 S JONES BLVD SUITE D3
LAS VEGAS NV
89103-3370
US

V. Phone/Fax

Practice location:
  • Phone: 702-991-3150
  • Fax: 866-658-4052
Mailing address:
  • Phone: 702-991-3150
  • Fax: 866-658-4052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: