Healthcare Provider Details

I. General information

NPI: 1558129213
Provider Name (Legal Business Name): MARYAN HERSHEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2024
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10120 S EASTERN AVE STE 207
HENDERSON NV
89052-3926
US

IV. Provider business mailing address

10120 S EASTERN AVE STE 207
HENDERSON NV
89052-3926
US

V. Phone/Fax

Practice location:
  • Phone: 702-677-3086
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: