Healthcare Provider Details

I. General information

NPI: 1871091843
Provider Name (Legal Business Name): MARIE ESCASIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2018
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2775 FREMONT ST
LAS VEGAS NV
89104-2238
US

IV. Provider business mailing address

1800 BANABA LN
LAS VEGAS NV
89156-6891
US

V. Phone/Fax

Practice location:
  • Phone: 702-287-4783
  • Fax:
Mailing address:
  • Phone: 702-586-8176
  • 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: