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NPI Code Detail

MEDICARE: IN GOOD HEALTH PROFESSIONAL CORPORATION

MEDICARE: IN GOOD HEALTH PROFESSIONAL CORPORATION
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
1261QP2300XPrimary Care Clinic/Center
2363LG0600XGerontology Nurse Practitioner

General Provider Information

NPI Number : 1770163214
Entity Type Code : Organization
Provider Name (Legal Business Name) : IN GOOD HEALTH PROFESSIONAL CORPORATION
Provider Business Mailing Address
First Line : 5920 S RAINBOW BLVD STE 5
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-4209
Country : US
Telephone Number : 702-522-6108
Fax Number : 702-989-4805
Provider Business Practice Location Address
First Line : 5495 S RAINBOW BLVD STE 202B
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-1873
Country : US
Telephone Number : 702-522-6108
Fax Number : 702-989-4805
Authorized Official
Title or Position : OWNER
Name : THOMAS SHARON
Credential : NP
Telephone Number : 702-522-6108
Provider Enumeration Date : 04/09/2021
Last Update Date : 08/31/2023

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Directions to “IN GOOD HEALTH PROFESSIONAL CORPORATION ” Practice Location

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