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General NPI Number Information
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NPI Number | 1588507966
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Entity Type | Organization
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Legal Business Name | NEURO REVOLT PSYCHIATRY PLLC
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Dates
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Enumeration Date | 04/11/2026
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Last Update Date | 04/24/2026
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Provider Practice Location Address
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Address Line | 8778 S MARYLAND PKWY STE 110
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City | LAS VEGAS
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State | NV
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Zip | 89123-6705
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Country | US
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Telephone | 725-292-2130
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Fax |
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Provider Business Mailing Address
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Address Line | 6592 N DECATUR BLVD STE 150 PMB #129
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City | LAS VEGAS
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State | NV
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Zip | 89131-1040
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIC NURSE PRACTITIONER
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Name | MARIAH ANGUITA
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Credential | APRN, PMHNP-BC
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Telephone | 725-292-2130
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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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