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NPI Code Detail

MEDICARE: PHYLLIS B. VISCONTE LPN

MEDICARE: PHYLLIS B. VISCONTE LPN
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
1164W00000XLicensed Practical NurseLPN14436NV
2164W00000XLicensed Practical Nurse249859-1NY

General Provider Information

NPI Number : 1427388073
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHYLLIS B. VISCONTE LPN
Provider Business Mailing Address
First Line : 9258 ALTA MONTE CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89178-5506
Country : US
Telephone Number : 702-405-9160
Fax Number :
Provider Business Practice Location Address
First Line : 9258 ALTA MONTE CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89178-5506
Country : US
Telephone Number : 702-405-9160
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2010
Last Update Date : 01/04/2010

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