Healthcare Provider Details

I. General information

NPI: 1003657123
Provider Name (Legal Business Name): HOMETOWN HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2024
Last Update Date: 09/15/2024
Certification Date: 09/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 S IRVING RD
BEATTY NV
89003-8098
US

IV. Provider business mailing address

3420 W DONNER ST
PAHRUMP NV
89048-5087
US

V. Phone/Fax

Practice location:
  • Phone: 775-990-1414
  • Fax:
Mailing address:
  • Phone: 775-537-8621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARKEETA DAWN ARAUJO
Title or Position: MANAGER
Credential: APRN
Phone: 473-427-5655