Provider Demographics
NPI:1760952360
Name:HUNTLY, MARY BRIDGET (NP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:BRIDGET
Last Name:HUNTLY
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:7975 W SAHARA AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-7916
Mailing Address - Country:US
Mailing Address - Phone:725-205-2547
Mailing Address - Fax:725-240-7742
Practice Address - Street 1:7975 W SAHARA AVE STE 101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-7916
Practice Address - Country:US
Practice Address - Phone:725-205-2457
Practice Address - Fax:725-240-7742
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2023-10-04
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Provider Licenses
StateLicense IDTaxonomies
NVF09180993363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care