Provider Demographics
NPI:1609644905
Name:NEVADA MEDICAL AND PAIN INSTITUTE
Entity Type:Organization
Organization Name:NEVADA MEDICAL AND PAIN INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEREMIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:UMEH
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:702-863-9247
Mailing Address - Street 1:70 S NV 160
Mailing Address - Street 2:104
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048
Mailing Address - Country:US
Mailing Address - Phone:702-863-9247
Mailing Address - Fax:725-205-0013
Practice Address - Street 1:70 S NV 160
Practice Address - Street 2:104
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048
Practice Address - Country:US
Practice Address - Phone:702-863-9247
Practice Address - Fax:725-205-0013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty