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General NPI Number Information
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NPI Number | 1598522898
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Entity Type | Individual
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Provider Name | DANIELLE MEMMOTT APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/04/2024
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 1550 N GREEN VALLEY PKWY
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City | HENDERSON
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State | NV
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Zip | 89074-7108
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Country | US
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Telephone | 702-666-0493
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Fax |
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Provider Business Mailing Address
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Address Line | 4414 OUTLOOK VISTA AVE
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89084-4963
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Country | US
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Telephone | 702-767-1330
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 819447
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 819447
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License Number State | NV
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