| Inner Healing Center | |
|
1703 Civic Center Dr Ste 2 North Las Vegas NV 89030-7273 | |
| (702) 481-3366 | |
| Not Available |
| Full Name | Inner Healing Center |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1703 Civic Center Dr Ste 2, North Las Vegas, Nevada |
| Authorized Official Name and Position | Michelle Wyatt (ADMIN) |
| Authorized Official Contact | 7029291142 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner Healing Center 1703 Civic Center Dr Ste 2 North Las Vegas NV 89030-7273 Ph: (702) 481-3366 | Inner Healing Center 1703 Civic Center Dr Ste 2 North Las Vegas NV 89030-7273 Ph: (702) 481-3366 |
| NPI Number | 1831783141 |
|---|---|
| Provider Enumeration Date | 02/26/2021 |
| Last Update Date | 11/08/2021 |
| Medicare PECOS PAC ID | 9234528829 |
|---|---|
| Medicare Enrollment ID | O20211122000242 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831783141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Rosette Sandrine Makon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700302445 PECOS PAC ID: 2365711363 Enrollment ID: I20190326001870 |
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