Healthcare Provider Details

I. General information

NPI: 1215365176
Provider Name (Legal Business Name): A'VAUNTAE BIGGS RN, LMFTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2013
Last Update Date: 06/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7391 W CHARLESTON BLVD SUITE 120
LAS VEGAS NV
89117-1501
US

IV. Provider business mailing address

4788 CASA RUSTICA CT
LAS VEGAS NV
89147-8563
US

V. Phone/Fax

Practice location:
  • Phone: 702-485-8470
  • Fax:
Mailing address:
  • Phone: 478-714-6570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number11066A
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number243364
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN92771
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: