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General NPI Number Information
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NPI Number | 1467387563
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Entity Type | Individual
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Provider Name | CARISSA NOVA
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Gender | Female
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Dates
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Enumeration Date | 06/17/2026
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Last Update Date | 06/17/2026
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Provider Practice Location Address
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Address Line | 3120 S RAINBOW BLVD STE 201
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City | LAS VEGAS
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State | NV
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Zip | 89146-6235
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Country | US
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Telephone | 702-749-3110
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Fax |
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Provider Business Mailing Address
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Address Line | 10143 SKYE SADDLE AVE
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City | LAS VEGAS
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State | NV
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Zip | 89166-6597
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Country | US
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Telephone | 661-839-6784
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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 | 902884
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License Number State | NV
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