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General NPI Number Information
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NPI Number | 1033873799
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Entity Type | Individual
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Provider Name | TIMISE BROUGH FNP
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Gender | Female
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Dates
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Enumeration Date | 10/28/2021
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Last Update Date | 12/21/2021
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Provider Practice Location Address
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Address Line | 9300 W SUNSET RD
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City | LAS VEGAS
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State | NV
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Zip | 89148-4844
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Country | US
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Telephone | 702-916-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 9300 W SUNSET RD
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City | LAS VEGAS
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State | NV
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Zip | 89148-4844
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Country | US
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Telephone | 702-916-7800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN87812
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 848106
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License Number State | NV
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