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General NPI Number Information
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NPI Number | 1922671049
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Entity Type | Organization
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Legal Business Name | DITHRA COTTON-LEWIS APRN FNP-C LLC
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Dates
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Enumeration Date | 07/19/2021
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Last Update Date | 12/02/2021
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Provider Practice Location Address
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Address Line | 8225 W SAHARA AVE STE C
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City | LAS VEGAS
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State | NV
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Zip | 89117-8929
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Country | US
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Telephone | 702-326-2340
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Fax |
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Provider Business Mailing Address
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Address Line | 6920 S CIMARRON RD STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89113-2135
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Country | US
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Telephone | 702-326-2340
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Fax | 702-462-9328
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | MUHAMMAD NAEEM
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Credential |
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Telephone | 307-223-2266
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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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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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