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NPI Code Detail

MEDICARE: TISHA WATKINS

MEDICARE:   TISHA  WATKINS
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1346062395
Entity Type Code : Individual
Provider Name (Legal Business Name) : TISHA WATKINS
Provider Business Mailing Address
First Line : 6575 W TROPICANA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-4392
Country : US
Telephone Number : 702-695-5253
Fax Number : 702-695-5253
Provider Business Practice Location Address
First Line : 6575 W TROPICANA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-4392
Country : US
Telephone Number : 702-695-5253
Fax Number : 702-695-5253
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2024
Last Update Date : 10/30/2024

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Directions to “ TISHA WATKINS ” Practice Location

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