Healthcare Provider Details

I. General information

NPI: 1205313095
Provider Name (Legal Business Name): NEVADA FIRST ASSIST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2018
Last Update Date: 07/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 SAND HAWK CT
LAS VEGAS NV
89129-5350
US

IV. Provider business mailing address

4755 SAND HAWK CT
LAS VEGAS NV
89129-5350
US

V. Phone/Fax

Practice location:
  • Phone: 702-964-3476
  • Fax:
Mailing address:
  • Phone: 702-964-3476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN59892
License Number State

VIII. Authorized Official

Name: DEBORAH JOHNSON-HILLOCK
Title or Position: SOLE MEMBER
Credential:
Phone: 702-964-3476