Healthcare Provider Details

I. General information

NPI: 1700355708
Provider Name (Legal Business Name): MELISSA ANN PAEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2018
Last Update Date: 11/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 W PIONEER BLVD STE 204
MESQUITE NV
89027-1406
US

IV. Provider business mailing address

100 N GRAPEVINE RD APT 7S
MESQUITE NV
89027-5112
US

V. Phone/Fax

Practice location:
  • Phone: 702-345-4065
  • Fax: 702-345-4077
Mailing address:
  • Phone: 702-971-1002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: