Healthcare Provider Details

I. General information

NPI: 1194335851
Provider Name (Legal Business Name): NICHOL YOZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2020
Last Update Date: 06/14/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6128 W SAHARA AVE
LAS VEGAS NV
89146-3051
US

IV. Provider business mailing address

4040 S EASTERN AVE STE 300
LAS VEGAS NV
89119-0854
US

V. Phone/Fax

Practice location:
  • Phone: 702-598-2048
  • Fax:
Mailing address:
  • Phone: 702-463-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number872614
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: