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General NPI Number Information
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NPI Number | 1053963256
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Entity Type | Organization
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Legal Business Name | NEVADA HEALTH ALLIANCE INC
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Dates
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Enumeration Date | 07/09/2019
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 601 S RANCHO DR STE D34
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City | LAS VEGAS
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State | NV
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Zip | 89106-4874
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Country | US
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Telephone | 725-207-8109
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Fax |
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Provider Business Mailing Address
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Address Line | 601 S RANCHO DR STE D34
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City | LAS VEGAS
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State | NV
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Zip | 89106-4874
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Country | US
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Telephone | 725-207-8109
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Fax |
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Authorized Official
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Title or Position | BILLING AND CREDENTIALING MANAGER
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Name | SADE MARTIN
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Credential |
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Telephone | 702-852-6633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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