MEDICARE: UNISA NP SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1114656295
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNISA NP SERVICES LLC

Provider Business Mailing Address
First Line	:	3090 VILLANELLE AVE
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89044-0555
Country	:	US
Telephone Number	:	202-203-8663
Fax Number	:

Provider Business Practice Location Address
First Line	:	7036 S DURANGO DR STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2023
Country	:	US
Telephone Number	:	702-485-5488
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MARLENE UNISA
Credential	:	DNP, APRN, FNP-C
Telephone Number	:	202-203-8663

Provider Enumeration Date	:	06/06/2022
Last Update Date	:	06/06/2022

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Directions to “UNISA NP SERVICES LLC ” Practice Location

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