Healthcare Provider Details

I. General information

NPI: 1164024865
Provider Name (Legal Business Name): FAITH TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2020
Last Update Date: 11/09/2020
Certification Date: 11/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4361 APONTE ST APT 203
LAS VEGAS NV
89115-1632
US

IV. Provider business mailing address

5250 MISSION CARMEL LN APT 106
LAS VEGAS NV
89107-2756
US

V. Phone/Fax

Practice location:
  • Phone: 702-904-2819
  • Fax:
Mailing address:
  • Phone: 702-348-9833
  • 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: