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General NPI Number Information
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NPI Number | 1245113836
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Entity Type | Individual
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Provider Name | AMBER MEDINA PMHNP
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Gender | Female
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Dates
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Enumeration Date | 07/30/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 911 N BUFFALO DR # 206213
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City | LAS VEGAS
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State | NV
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Zip | 89128-0379
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Country | US
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Telephone | 702-405-8088
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Fax |
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Provider Business Mailing Address
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Address Line | 1909 BIRCH ST
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City | LAS VEGAS
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State | NV
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Zip | 89102-4405
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Country | US
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Telephone |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 892434
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License Number State | NV
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