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General NPI Number Information
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NPI Number | 1669107165
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Entity Type | Individual
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Provider Name | WHISLY NG FNP-C
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Gender | Male
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Dates
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Enumeration Date | 07/19/2022
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Last Update Date | 07/19/2022
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Provider Practice Location Address
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Address Line | 9065 S PECOS RD STE 190
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City | HENDERSON
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State | NV
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Zip | 89074-6605
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Country | US
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Telephone | 702-888-3148
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Fax | 702-888-3158
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Provider Business Mailing Address
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Address Line | 2370 CORPORATE CIR STE 300
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City | HENDERSON
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State | NV
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Zip | 89074-7760
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Country | US
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Telephone | 702-910-3950
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 853705
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License Number State | NV
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