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General NPI Number Information
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NPI Number | 1508378977
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Entity Type | Organization
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Legal Business Name | HEMOSTASIS AND THROMBOSIS CENTER OF NEVADA
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Dates
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Enumeration Date | 10/25/2017
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Last Update Date | 10/20/2022
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Provider Practice Location Address
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Address Line | 8352 W WARM SPRINGS RD STE 200
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City | LAS VEGAS
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State | NV
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Zip | 89113
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Country | US
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Telephone | 702-330-0555
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Fax | 702-832-1128
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Provider Business Mailing Address
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Address Line | 8352 W WARM SPRINGS RD STE 200
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City | LAS VEGAS
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State | NV
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Zip | 89113-3629
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Country | US
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Telephone | 702-330-0555
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Fax | 702-832-1128
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Authorized Official
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Title or Position | DELEGATED OFFICIAL
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Name | AMBER MARIE FEDERIZO
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Credential | APRN
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Telephone | 702-506-8199
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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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Taxonomy #2
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Taxonomy Code | 207RH0000X
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Taxonomy Name | Hematology (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 163WH0500X
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Taxonomy Name | Hemodialysis Registered Nurse
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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