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General NPI Number Information
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NPI Number | 1396137022
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Entity Type | Organization
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Legal Business Name | ADVANCED PRACTICE NURSING SPECIALISTS, LLC
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Dates
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Enumeration Date | 03/04/2015
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 9205 W RUSSELL RD STE 305
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City | LAS VEGAS
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State | NV
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Zip | 89148-1446
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Country | US
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Telephone | 917-628-8969
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Fax | 702-476-9233
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Provider Business Mailing Address
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Address Line | 9205 W RUSSELL RD STE 305
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City | LAS VEGAS
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State | NV
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Zip | 89148-1446
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Country | US
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Telephone | 917-628-8969
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Fax | 702-476-9233
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Authorized Official
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Title or Position | CEO
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Name | MR. DAVID J MEMMOLI
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Credential | FNP-C
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Telephone | 917-628-8969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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