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General NPI Number Information
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NPI Number | 1861851222
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Entity Type | Organization
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Legal Business Name | COMPLETE HEALTH AND WELLNESS
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Dates
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Enumeration Date | 02/14/2016
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Last Update Date | 02/14/2016
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Provider Practice Location Address
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Address Line | 2920 N GREEN VALLEY PKWY BUILDING 2, STE 215
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City | HENDERSON
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State | NV
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Zip | 89014-0406
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Country | US
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Telephone | 702-750-0002
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Fax | 888-534-3176
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Provider Business Mailing Address
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Address Line | 2920 N GREEN VALLEY PKWY BUILDING 2, STE 215
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City | HENDERSON
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State | NV
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Zip | 89014-0406
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Country | US
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Telephone | 702-750-0002
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Fax | 888-534-3176
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MR. GREGORY MARTIN
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Credential | APRN
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Telephone | 702-600-9037
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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 | APRN00437
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License Number State | NV
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