MEDICARE: ANDREA HASTINGS

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	171M00000X	Case Manager/Care Coordinator
2	106S00000X	Behavior Technician	RBT3708	NV

General Provider Information

NPI Number	:	1891423026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA HASTINGS

Provider Business Mailing Address
First Line	:	8064 W SAHARA AVE STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1998
Country	:	US
Telephone Number	:	702-301-5575
Fax Number	:

Provider Business Practice Location Address
First Line	:	8064 W SAHARA AVE STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1998
Country	:	US
Telephone Number	:	702-301-5575
Fax Number	:

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

Provider Enumeration Date	:	08/15/2022
Last Update Date	:	08/31/2023

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Directions to “ ANDREA HASTINGS ” Practice Location

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