MEDICARE: MS. MARIA GUADALUPE HERNANDEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	372500000X	Chore Provider
2	103K00000X	Behavior Analyst
3	372600000X	Adult Companion
4	3747A0650X	Attendant Care Provider
5	376J00000X	Homemaker
6	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1013215490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIA GUADALUPE HERNANDEZ

Provider Business Mailing Address
First Line	:	1810 E SAHARA AVE STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-3735
Country	:	US
Telephone Number	:	702-207-6782
Fax Number	:

Provider Business Practice Location Address
First Line	:	2860 E FLAMINGO RD STE K
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5270
Country	:	US
Telephone Number	:	702-318-5005
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2011
Last Update Date	:	05/15/2019

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