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General NPI Number Information
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NPI Number | 1144946765
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Entity Type | Organization
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Legal Business Name | OLIVE BRANCH PSYCHIATRICS
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Dates
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Enumeration Date | 10/14/2022
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Last Update Date | 04/21/2023
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Provider Practice Location Address
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Address Line | 6628 SKY POINTE DR STE 103
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City | LAS VEGAS
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State | NV
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Zip | 89131-4071
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Country | US
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Telephone | 702-550-9199
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Fax | 702-935-8946
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Provider Business Mailing Address
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Address Line | PO BOX 750182
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City | LAS VEGAS
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State | NV
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Zip | 89136-0182
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Country | US
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Telephone | 702-561-7564
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | JANELLE CAROLYN WELCH-OLIVER
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Credential | APRN
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Telephone | 702-550-9199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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