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NPI Code Detail

MEDICARE: DONNA JANE WYRENS

MEDICARE: DONNA JANE WYRENS
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
1372500000XChore ProviderNV
2372600000XAdult CompanionNV
33747A0650XAttendant Care ProviderNV
4376J00000XHomemakerNV
53747P1801XPersonal Care AttendantNV

General Provider Information

NPI Number : 1679068985
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONNA JANE WYRENS
Provider Business Mailing Address
First Line : 3145 E FLAMINGO RD APT 2113
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-4362
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6725 S EASTERN AVE STE 1
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-3949
Country : US
Telephone Number : 702-646-2722
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2018
Last Update Date : 06/28/2018

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