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General NPI Number Information
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NPI Number | 1588263248
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Entity Type | Organization
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Legal Business Name | MAKON AMAZING GIFTED HANDS PLLC
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Dates
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Enumeration Date | 10/22/2020
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Last Update Date | 01/18/2023
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Provider Practice Location Address
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Address Line | 3430 E FLAMINGO RD STE 350
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City | LAS VEGAS
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State | NV
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Zip | 89121-5067
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Country | US
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Telephone | 469-989-2697
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Fax |
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Provider Business Mailing Address
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Address Line | 510 E MARDON AVE
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City | LAS VEGAS
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State | NV
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Zip | 89123-1276
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Country | US
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Telephone | 469-989-2697
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Fax | 725-205-5617
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Authorized Official
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Title or Position | AGNP-BC, WCC, PMHNP-BC
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Name | MISS ROSETTE SANDRINE MAKON
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Credential | NP
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Telephone | 469-989-2697
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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