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General NPI Number Information
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NPI Number | 1730968421
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Entity Type | Individual
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Provider Name | MICHAEL HURNDON MAED
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Gender | Male
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Dates
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Enumeration Date | 09/22/2023
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Last Update Date | 09/29/2023
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Provider Practice Location Address
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Address Line | 860 S RANCHO DR STE 10
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City | LAS VEGAS
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State | NV
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Zip | 89106-3828
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Country | US
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Telephone | 702-268-8555
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Fax | 702-272-2541
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Provider Business Mailing Address
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Address Line | 860 S RANCHO DR STE 10
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City | LAS VEGAS
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State | NV
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Zip | 89106-3828
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Country | US
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Telephone | 702-268-8555
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Fax | 702-272-2541
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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