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NPI Code Detail

MEDICARE: DIGNUS MIRUS MEDICAL CONSULTING PLLC

MEDICARE: DIGNUS MIRUS MEDICAL CONSULTING PLLC
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
1363LF0000XFamily Nurse Practitioner

General Provider Information

NPI Number : 1215764097
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIGNUS MIRUS MEDICAL CONSULTING PLLC
Provider Business Mailing Address
First Line : 3535 EXECUTIVE TERMINAL DR STE 110
Second Line :
City : HENDERSON
State : NV
Zip : 89052-4269
Country : US
Telephone Number : 888-346-2161
Fax Number : 702-618-7256
Provider Business Practice Location Address
First Line : 8905 W POST RD STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-2429
Country : US
Telephone Number : 888-346-2161
Fax Number : 702-618-7256
Authorized Official
Title or Position : CEO
Name : ANGELA J MCLENDON
Credential : FNP-C
Telephone Number : 702-618-7255
Provider Enumeration Date : 09/17/2024
Last Update Date : 09/17/2024

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Directions to “DIGNUS MIRUS MEDICAL CONSULTING PLLC ” Practice Location

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