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General NPI Number Information
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NPI Number | 1386368744
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Entity Type | Organization
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Legal Business Name | NEVADA BRAIN HEALTH PLLC
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Dates
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Enumeration Date | 09/29/2022
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Last Update Date | 09/29/2022
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Provider Practice Location Address
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Address Line | 9811 W CHARLESTON BLVD STE 2-172
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City | LAS VEGAS
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State | NV
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Zip | 89117-7528
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Country | US
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Telephone | 501-258-1293
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Fax |
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Provider Business Mailing Address
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Address Line | 9811 W CHARLESTON BLVD STE 2-172
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City | LAS VEGAS
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State | NV
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Zip | 89117-7528
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Country | US
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Telephone | 501-258-1293
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Fax |
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Authorized Official
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Title or Position | OWNER/ PROVIDER
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Name | REBECCA ISABEL CAMPALANS
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Credential | NURSE PRACTITIONER
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Telephone | 501-258-1293
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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