Healthcare Provider Details

I. General information

NPI: 1265269328
Provider Name (Legal Business Name): INSTAMOBILE LVNV PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2024
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3225 MCLEOD DR STE 100
LAS VEGAS NV
89121-2257
US

IV. Provider business mailing address

PO BOX 550
RIVERTON UT
84065-0550
US

V. Phone/Fax

Practice location:
  • Phone: 801-919-3008
  • Fax: 801-960-1780
Mailing address:
  • Phone: 801-919-3008
  • Fax: 801-960-1780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALISA ANDERSON
Title or Position: BILLING CREDENTIALING ADMIN
Credential:
Phone: 801-561-8398