Individual provider · Type 1 NPI

Lieutenant Johnson Superville, PhD

Psychiatric/Mental Health Nurse Practitioner · Henderson, NV

NPI number 1790458156 Active

Practice location

6301 Mountain Vista St Ste 104
Henderson, NV 89014-2365

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X847157 (NV)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1790458156

Lieutenant Johnson Superville, PhD's National Provider Identifier is 1790458156, issued on Jul 30, 2021. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Henderson, NV. The record was last updated on Aug 31, 2026.