LIEUTENANT SUPERVILLE, PH.D

Nurse Practitioner - Psychiatric/Mental Health

Active Individual
NPI: 1790458156

Practice Address

6301 MOUNTAIN VISTA ST STE 104
Henderson, NV 89014

Phone: (512) 201-6766

Specialties

Specialty Code Primary License
Nurse Practitioner - Psychiatric/Mental Health 363LP0808X Yes 847157 (NV)

Frequently Asked Questions

NPI 1790458156 is the National Provider Identifier for LIEUTENANT SUPERVILLE, PH.D, a Nurse Practitioner - Psychiatric/Mental Health provider located in Henderson, NV. This NPI was enumerated on July 30, 2021.
LIEUTENANT SUPERVILLE, PH.D practices at 6301 MOUNTAIN VISTA ST STE 104, Henderson, NV 89014.

Quick Facts

NPI
1790458156
Type
Individual
Enumerated
Jul 30, 2021
Last Updated
Dec 5, 2025

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