MEDICARE: NEW GENERATIONS HEALTH & WELLNESS 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	363LF0000X	Family Nurse Practitioner	APRN001120	NV

General Provider Information

NPI Number	:	1184053373
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW GENERATIONS HEALTH & WELLNESS LLC

Provider Business Mailing Address
First Line	:	PO BOX 335247
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89033-5247
Country	:	US
Telephone Number	:	702-526-7699
Fax Number	:	702-272-2312

Provider Business Practice Location Address
First Line	:	6349 BLUSHING WILLOW ST
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89081-3324
Country	:	US
Telephone Number	:	702-526-7699
Fax Number	:	702-272-2312

Authorized Official
Title or Position	:	OWNER
Name	:	BECKY SUE CHRISTENSEN
Credential	:	ARNP
Telephone Number	:	702-526-7699

Provider Enumeration Date	:	11/07/2013
Last Update Date	:	11/07/2013

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