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NPI Code Detail

MEDICARE: GENET MEKONNEN

MEDICARE: GENET MEKONNEN
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 : 1487139150
Entity Type Code : Individual
Provider Name (Legal Business Name) : GENET MEKONNEN
Provider Business Mailing Address
First Line : 1771 E FLAMINGO RD STE 220A
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-0850
Country : US
Telephone Number : 702-369-9828
Fax Number :
Provider Business Practice Location Address
First Line : 1771 E FLAMINGO RD STE 220A
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-0850
Country : US
Telephone Number : 571-244-2440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2018
Last Update Date : 09/28/2018

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Directions to “ GENET MEKONNEN ” Practice Location

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