Healthcare Provider Details

I. General information

NPI: 1104449081
Provider Name (Legal Business Name): VASILIKA XHURKA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2020
Last Update Date: 05/26/2020
Certification Date: 05/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2780 S JONES BLVD # 105B
LAS VEGAS NV
89146-5628
US

IV. Provider business mailing address

7932 CORONADO ISLAND ST
LAS VEGAS NV
89139-6271
US

V. Phone/Fax

Practice location:
  • Phone: 702-333-1488
  • 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: