Healthcare Provider Details

I. General information

NPI: 1598435620
Provider Name (Legal Business Name): NORA M HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2021
Last Update Date: 09/20/2021
Certification Date: 09/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4850 W FLAMINGO RD STE 25A&B
LAS VEGAS NV
89103-3705
US

IV. Provider business mailing address

11052 PIEDMONT VALLEY AVE
LAS VEGAS NV
89144-4017
US

V. Phone/Fax

Practice location:
  • Phone: 702-871-9917
  • Fax: 702-871-9918
Mailing address:
  • Phone: 702-525-3022
  • 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: