Healthcare Provider Details

I. General information

NPI: 1881205839
Provider Name (Legal Business Name): LEILANY GEBA BUSINESS CONSULTANT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2020
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8845 FIRST LADY AVE
LAS VEGAS NV
89148-3894
US

IV. Provider business mailing address

8845 FIRST LADY AVE
LAS VEGAS NV
89148-3894
US

V. Phone/Fax

Practice location:
  • Phone: 702-488-4918
  • Fax:
Mailing address:
  • Phone: 702-488-4918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: