1700309960 NPI number — DR. NILA EDONNA STURLIN PHARMD, BCPS, BC-ADM

Table of content: DR. NILA EDONNA STURLIN PHARMD, BCPS, BC-ADM (NPI 1700309960)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700309960 NPI number — DR. NILA EDONNA STURLIN PHARMD, BCPS, BC-ADM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STURLIN
Provider First Name:
NILA
Provider Middle Name:
EDONNA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD, BCPS, BC-ADM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PENN
Provider Other First Name:
NILA
Provider Other Middle Name:
EDONNA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1700309960
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/19/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1700 WHEELER PEAK DRIVE
Provider Second Line Business Mailing Address:
NEVADA HEALTH CENTERS WELLNESS CLINIC
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89106-2150
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-563-4625
Provider Business Mailing Address Fax Number:
702-991-4058

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1700 WHEELER PEAK DRIVE
Provider Second Line Business Practice Location Address:
NEVADA HEALTH CENTERS WELLNESS CLINIC
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89106-2150
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-563-4625
Provider Business Practice Location Address Fax Number:
702-991-4058
Provider Enumeration Date:
07/19/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1835P1200X , with the licence number:  3158088 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 183500000X , with the licence number: 19628 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)