Healthcare Provider Details

I. General information

NPI: 1174945232
Provider Name (Legal Business Name): SOUTHERN NEVADA HEALTH DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2014
Last Update Date: 01/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 SHADOW LN
LAS VEGAS NV
89106-4363
US

IV. Provider business mailing address

400 SHADOW LN
LAS VEGAS NV
89106-4363
US

V. Phone/Fax

Practice location:
  • Phone: 702-759-0803
  • Fax: 702-868-2821
Mailing address:
  • Phone: 702-759-0803
  • Fax: 702-868-2821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberRN51989
License Number StateNV

VIII. Authorized Official

Name: ELAINE GLASER
Title or Position: DIRECTOR ADMINISTRATIVE SERVICES
Credential:
Phone: 702-759-1204