Healthcare Provider Details

I. General information

NPI: 1528854890
Provider Name (Legal Business Name): NADEZHDA ILNITSKAIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3225 S RAINBOW BLVD STE 102
LAS VEGAS NV
89146-6216
US

IV. Provider business mailing address

3866 FALCON SPRINGS DR
LAS VEGAS NV
89147-4277
US

V. Phone/Fax

Practice location:
  • Phone: 702-463-0085
  • Fax:
Mailing address:
  • Phone: 702-463-0085
  • 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: