Healthcare Provider Details

I. General information

NPI: 1154109031
Provider Name (Legal Business Name): DYNA FAELNAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2023
Last Update Date: 09/20/2023
Certification Date: 09/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3975 W QUAIL AVE STE 10
LAS VEGAS NV
89118-3002
US

IV. Provider business mailing address

3975 W QUAIL AVE STE 10
LAS VEGAS NV
89118-3002
US

V. Phone/Fax

Practice location:
  • Phone: 702-771-4202
  • Fax: 888-881-0459
Mailing address:
  • Phone: 702-771-4202
  • Fax: 888-881-0459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: