Healthcare Provider Details

I. General information

NPI: 1801262266
Provider Name (Legal Business Name): QUENNIE CAJANDING RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2015
Last Update Date: 08/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N 1ST ST
LAS VEGAS NV
89101-1904
US

IV. Provider business mailing address

600 N 1ST ST
LAS VEGAS NV
89101-1904
US

V. Phone/Fax

Practice location:
  • Phone: 702-463-0110
  • Fax: 702-463-0166
Mailing address:
  • Phone: 702-463-0110
  • Fax: 702-463-0166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberRN74273
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: