Healthcare Provider Details

I. General information

NPI: 1861845059
Provider Name (Legal Business Name): ADVANCED CLINICAL PROFESSIONALS OF NEVADA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2016
Last Update Date: 04/17/2020
Certification Date: 04/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7670 W SAHARA AVE STE 2
LAS VEGAS NV
89117-2751
US

IV. Provider business mailing address

7670 W SAHARA AVE STE 2
LAS VEGAS NV
89117-2751
US

V. Phone/Fax

Practice location:
  • Phone: 702-457-7400
  • Fax: 702-457-7401
Mailing address:
  • Phone: 702-613-1190
  • Fax: 702-457-7401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN001449
License Number StateNV

VIII. Authorized Official

Name: KIMBERLY ANNE PHILLIPS
Title or Position: OWNER/OPERATOR
Credential: BC-NP
Phone: 702-613-1190