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General NPI Number Information
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NPI Number | 1659180891
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Entity Type | Organization
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Legal Business Name | DVH NP IN PSYCHIATRY SERVICES, PLLC
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Dates
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Enumeration Date | 01/02/2025
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 5940 S RAINBOW BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89118-2506
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Country | US
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Telephone | 347-573-9479
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Fax | 347-745-5913
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Provider Business Mailing Address
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Address Line | 1887 WHITNEY MESA DR PMB 1332
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City | HENDERSON
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State | NV
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Zip | 89014-2069
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Country | US
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Telephone | 347-573-9479
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Fax | 347-745-5913
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Authorized Official
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Title or Position | PMHNP
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Name | DUSTIN BRADFORD VON HOLTEN
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Credential | PMHNP
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Telephone | 347-573-9479
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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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