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General NPI Number Information
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NPI Number | 1750128252
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Entity Type | Organization
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Legal Business Name | SOUTHERN NEVADA VA MEDICAL CENTER
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Dates
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Enumeration Date | 07/11/2024
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Last Update Date | 07/11/2024
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Provider Practice Location Address
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Address Line | 6900 N PECOS RD
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89086-4400
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Country | US
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Telephone | 709-791-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 6900 N PECOS RD
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89086-4400
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Country | US
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Telephone | 709-791-9000
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Fax |
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Authorized Official
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Title or Position | PRIMARY CARE NURSE PRACTITIONER
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Name | ANTHONY DENINA
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Credential | NP
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Telephone | 702-791-9040
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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 |
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License Number State |
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