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General NPI Number Information
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NPI Number | 1972235638
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Entity Type | Individual
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Provider Name | TORRIE PATRICE CLONTZ APRN
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Gender | Female
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Dates
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Enumeration Date | 06/30/2022
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Last Update Date | 06/30/2022
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Provider Practice Location Address
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Address Line | 620 SHADOW LN
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City | LAS VEGAS
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State | NV
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Zip | 89106-4119
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Country | US
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Telephone | 702-388-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 9433 VALLEY HILLS AVE
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City | LAS VEGAS
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State | NV
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Zip | 89134-0152
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Country | US
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Telephone | 562-665-5770
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 856877
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License Number State | NV
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