Provider Demographics
NPI:1396137022
Name:ADVANCED PRACTICE NURSING SPECIALISTS, LLC
Entity type:Organization
Organization Name:ADVANCED PRACTICE NURSING SPECIALISTS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:MEMMOLI
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:917-628-8969
Mailing Address - Street 1:9205 W RUSSELL RD STE 305
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-1446
Mailing Address - Country:US
Mailing Address - Phone:917-628-8969
Mailing Address - Fax:702-476-9233
Practice Address - Street 1:9205 W RUSSELL RD STE 305
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-1446
Practice Address - Country:US
Practice Address - Phone:917-628-8969
Practice Address - Fax:702-476-9233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-04
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty