Provider Demographics
NPI:1396527578
Name:THE HUMMINGBIRD HEALTH PLLC
Entity type:Organization
Organization Name:THE HUMMINGBIRD HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER: MEDICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:HANCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:702-525-6046
Mailing Address - Street 1:3030 VILLANELLE AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89044-0555
Mailing Address - Country:US
Mailing Address - Phone:702-525-6046
Mailing Address - Fax:702-745-0904
Practice Address - Street 1:4450 N TENAYA WAY STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-7136
Practice Address - Country:US
Practice Address - Phone:702-525-6046
Practice Address - Fax:702-745-0904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-20
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty