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General NPI Number Information
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NPI Number | 1700590965
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Entity Type | Organization
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Legal Business Name | LIV BEAUTIFUL LLC
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Dates
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Enumeration Date | 01/11/2023
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Last Update Date | 06/06/2023
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Provider Practice Location Address
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Address Line | 3200 SOARING GULLS DR STE 103
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City | LAS VEGAS
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State | NV
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Zip | 89129-2198
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Country | US
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Telephone | 702-201-1400
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Fax | 702-915-7514
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Provider Business Mailing Address
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Address Line | 3200 SOARING GULLS DR STE 103
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City | LAS VEGAS
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State | NV
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Zip | 89129-2198
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Country | US
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Telephone | 702-201-1400
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Fax | 702-915-7514
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Authorized Official
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Title or Position | OWNER
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Name | MICHELLE ANNE NORVELL
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Credential | APRN
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Telephone | 702-201-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State |
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