Healthcare Provider Details

I. General information

NPI: 1306824057
Provider Name (Legal Business Name): KATHLEEN A MENASCHE C.N.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

926 W. SUNSET RD. WELL HEAKTH QUALITY CARE # 200
LAS VEGAS NV
89148
US

IV. Provider business mailing address

10625 ARGENTS HILL DR
LAS VEGAS NV
89134-7353
US

V. Phone/Fax

Practice location:
  • Phone: 702-255-3547
  • Fax: 702-921-2419
Mailing address:
  • Phone: 702-860-4232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPN00237
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: