Healthcare Provider Details

I. General information

NPI: 1841780566
Provider Name (Legal Business Name): TLC FAMILY WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2018
Last Update Date: 04/05/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 PYRAMID WAY STE 206
SPARKS NV
89431-4470
US

IV. Provider business mailing address

1001 PYRAMID WAY STE 206
SPARKS NV
89431-4470
US

V. Phone/Fax

Practice location:
  • Phone: 775-799-8188
  • Fax: 602-354-9272
Mailing address:
  • Phone: 775-799-8188
  • Fax: 602-354-9272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH MELTON
Title or Position: OWNER, PROVIDER
Credential: APRN
Phone: 775-771-1390