Provider Demographics
NPI:1205647914
Name:MCCLINTOCK, AMY TIERNEY (PMHNP-C)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:TIERNEY
Last Name:MCCLINTOCK
Suffix:
Gender:F
Credentials:PMHNP-C
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:TIERNEY
Other - Last Name:ZORBAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 750182
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89136-0182
Mailing Address - Country:US
Mailing Address - Phone:828-450-4578
Mailing Address - Fax:
Practice Address - Street 1:6628 SKY POINTE DR STE 103
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-4071
Practice Address - Country:US
Practice Address - Phone:702-550-9199
Practice Address - Fax:702-935-8946
Is Sole Proprietor?:No
Enumeration Date:2025-01-14
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV890138363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty