Healthcare Provider Details

I. General information

NPI: 1588376776
Provider Name (Legal Business Name): LANAI MASON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2022
Last Update Date: 12/19/2022
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 W SAHARA AVE STE 800
LAS VEGAS NV
89102-4397
US

IV. Provider business mailing address

2300 W SAHARA AVE STE 800
LAS VEGAS NV
89102-4397
US

V. Phone/Fax

Practice location:
  • Phone: 702-604-2470
  • Fax: 725-605-5874
Mailing address:
  • Phone: 702-604-2470
  • Fax: 725-605-5874

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: