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General NPI Number Information
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NPI Number | 1962131789
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Entity Type | Organization
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Legal Business Name | AMEDURI HEALTH SERVICES LLC
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Dates
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Enumeration Date | 06/07/2022
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Last Update Date | 06/07/2022
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Provider Practice Location Address
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Address Line | 2110 E FLAMINGO RD STE 309
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City | LAS VEGAS
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State | NV
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Zip | 89119-5193
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Country | US
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Telephone | 702-551-0950
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Fax | 702-444-2944
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Provider Business Mailing Address
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Address Line | 3943 DELUGE DR
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City | LAS VEGAS
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State | NV
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Zip | 89129-6481
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHELLEY AMEDURI
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Credential | PMHNP
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Telephone | 808-895-9080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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