MEDICARE: DEOKCHOL PARISH FNP-BC

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	835784	NV

General Provider Information

NPI Number	:	1841885142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEOKCHOL PARISH FNP-BC

Provider Business Mailing Address
First Line	:	2345 VIA INSPIRADA # 336
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89044-1848
Country	:	US
Telephone Number	:	702-377-2105
Fax Number	:	877-682-6561

Provider Business Practice Location Address
First Line	:	1720 W HORIZON RIDGE PKWY STE 110
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89012-4896
Country	:	US
Telephone Number	:	702-623-3250
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2021
Last Update Date	:	06/19/2026

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Directions to “ DEOKCHOL PARISH FNP-BC” Practice Location

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