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General NPI Number Information
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NPI Number | 1114656295
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Entity Type | Organization
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Legal Business Name | UNISA NP SERVICES LLC
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Dates
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Enumeration Date | 06/06/2022
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Last Update Date | 06/06/2022
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Provider Practice Location Address
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Address Line | 7036 S DURANGO DR STE 200
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City | LAS VEGAS
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State | NV
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Zip | 89113-2023
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Country | US
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Telephone | 702-485-5488
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Fax |
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Provider Business Mailing Address
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Address Line | 3090 VILLANELLE AVE
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City | HENDERSON
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State | NV
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Zip | 89044-0555
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Country | US
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Telephone | 202-203-8663
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARLENE UNISA
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Credential | DNP, APRN, FNP-C
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Telephone | 202-203-8663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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