Healthcare Provider Details

I. General information

NPI: 1790646727
Provider Name (Legal Business Name): NAZARITA TABARES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3225 S RAINBOW BLVD UNIT 102-8
LAS VEGAS NV
89146-6239
US

IV. Provider business mailing address

3225 S RAINBOW BLVD UNIT 102-8
LAS VEGAS NV
89146-6239
US

V. Phone/Fax

Practice location:
  • Phone: 702-463-0085
  • Fax: 702-933-9329
Mailing address:
  • Phone: 702-463-0085
  • Fax: 702-933-9329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: