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General NPI Number Information
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NPI Number | 1114114865
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Entity Type | Organization
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Legal Business Name | FAMILY FIRST MEDICAL LLC
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Dates
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Enumeration Date | 09/26/2007
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Last Update Date | 10/10/2007
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Provider Practice Location Address
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Address Line | 1725 E WARM SPRINGS RD SUITE 12
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City | LAS VEGAS
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State | NV
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Zip | 89119-0420
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Country | US
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Telephone | 702-260-0577
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Fax |
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Provider Business Mailing Address
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Address Line | 1725 E WARM SPRINGS RD SUITE 12
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City | LAS VEGAS
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State | NV
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Zip | 89119-0420
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Country | US
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Telephone | 702-260-0577
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | DR. EVARISTA CHRISTIANA NNADI
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Credential | M.D
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Telephone | 702-260-0577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 10975
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License Number State | NV
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