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Contact Information

FORMA INTEGRATED HEALTHCARE
2655 S RAINBOW BLVD STE 410
LAS VEGAS, NV89146-5100
 Phone: 702-726-9722
 Fax: 702-906-0067
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
 

Family

103TF0000X 62 Psychologist, Clinical
 

Family

363LF0000X 50 Nurse Practitioner
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
 

Wound Care

163WW0000X
Indicates primary specialty

NPI Profile & details for FORMA INTEGRATED HEALTHCARE · (Female)

NPI # 1023964657
Status Active
Credentials
Entity Individual
Enumeration date 03/06/2026
Last updated 03/09/2026 - About 3 months ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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