Healthcare Provider Details

I. General information

NPI: 1760030597
Provider Name (Legal Business Name): EVELYN ZAPATA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2770 S MARYLAND PKWY STE 108
LAS VEGAS NV
89109-1564
US

IV. Provider business mailing address

2770 S MARYLAND PKWY STE 108
LAS VEGAS NV
89109-1564
US

V. Phone/Fax

Practice location:
  • Phone: 702-463-7779
  • Fax:
Mailing address:
  • Phone: 702-463-7779
  • 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: