Healthcare Provider Details

I. General information

NPI: 1548868284
Provider Name (Legal Business Name): KAMIA ANDERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2020
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8480 S EASTERN AVE STE F
LAS VEGAS NV
89123-2822
US

IV. Provider business mailing address

8480 S EASTERN AVE STE F
LAS VEGAS NV
89123-2822
US

V. Phone/Fax

Practice location:
  • Phone: 702-830-5325
  • Fax: 702-830-4385
Mailing address:
  • Phone: 702-830-5325
  • Fax: 702-830-4385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: