MEDICARE: ANITA HOUSTON

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
1	376J00000X	Homemaker

General Provider Information

NPI Number	:	1700607561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANITA HOUSTON

Provider Business Mailing Address
First Line	:	6666 W WASHINGTON AVE APT 123
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-1338
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6666 W WASHINGTON AVE APT 123
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-1338
Country	:	US
Telephone Number	:	702-580-5218
Fax Number	:

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

Provider Enumeration Date	:	10/23/2024
Last Update Date	:	10/23/2024

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Directions to “ ANITA HOUSTON ” Practice Location

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