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General NPI Number Information
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NPI Number | 1245833235
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Entity Type | Organization
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Legal Business Name | DESERT SKY MEDICAL LLC
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Dates
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Enumeration Date | 11/20/2020
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Last Update Date | 11/20/2020
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Provider Practice Location Address
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Address Line | 840 PINNACLE CT BLDG 10
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City | MESQUITE
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State | NV
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Zip | 89027-3303
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Country | US
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Telephone | 775-225-1414
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Fax | 775-225-1415
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Provider Business Mailing Address
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Address Line | 840 PINNACLE CT BLDG 10
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City | MESQUITE
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State | NV
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Zip | 89027-3303
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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 | OWNER
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Name | KRISTY LEANY
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Credential | NP
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Telephone | 435-669-0984
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal 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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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