Provider Demographics
NPI:1881269843
Name:PANACEA HEALTH AND WELLNESS, LLC
Entity type:Organization
Organization Name:PANACEA HEALTH AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:PATTERSON-HUNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:702-279-7241
Mailing Address - Street 1:6210 N JONES BLVD # 752763
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-4001
Mailing Address - Country:US
Mailing Address - Phone:702-279-7241
Mailing Address - Fax:
Practice Address - Street 1:9418 W LAKE MEAD BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-8312
Practice Address - Country:US
Practice Address - Phone:702-279-7241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-23
Last Update Date:2021-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty