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NPI Code Detail

MEDICARE: GRACIELA MACEDO

MEDICARE: GRACIELA MACEDO
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 : 1730798315
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACIELA MACEDO
Provider Business Mailing Address
First Line : 1005 TERMINAL WAY STE 125
Second Line :
City : RENO
State : NV
Zip : 89502-2198
Country : US
Telephone Number : 877-786-4999
Fax Number :
Provider Business Practice Location Address
First Line : 3128 VAN DER MEER ST
Second Line :
City : N LAS VEGAS
State : NV
Zip : 89030-5138
Country : US
Telephone Number : 725-203-8046
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2020
Last Update Date : 07/29/2020

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Directions to “ GRACIELA MACEDO ” Practice Location

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