Healthcare Provider Details

I. General information

NPI: 1548175946
Provider Name (Legal Business Name): SANIYAH LEWIS CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4423 W FLAMINGO RD
LAS VEGAS NV
89103-3703
US

IV. Provider business mailing address

4423 W FLAMINGO RD
LAS VEGAS NV
89103-3703
US

V. Phone/Fax

Practice location:
  • Phone: 702-458-1137
  • Fax:
Mailing address:
  • Phone: 702-458-1137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number876522
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: