Healthcare Provider Details

I. General information

NPI: 1952073181
Provider Name (Legal Business Name): ANA GUINA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2021
Last Update Date: 10/05/2021
Certification Date: 10/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6070 S FORT APACHE RD STE 110
LAS VEGAS NV
89148-5615
US

IV. Provider business mailing address

PO BOX 777851
HENDERSON NV
89077-7851
US

V. Phone/Fax

Practice location:
  • Phone: 702-839-0378
  • Fax: 702-380-1081
Mailing address:
  • Phone: 702-839-0378
  • Fax: 702-380-1081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: