Healthcare Provider Details

I. General information

NPI: 1346867009
Provider Name (Legal Business Name): BRANDACE JULIA SEXTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2020
Last Update Date: 06/29/2020
Certification Date: 06/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5405 CRUZ CREST CT
N LAS VEGAS NV
89081-4076
US

IV. Provider business mailing address

5405 CRUZ CREST CT
N LAS VEGAS NV
89081-4076
US

V. Phone/Fax

Practice location:
  • Phone: 702-290-8070
  • Fax:
Mailing address:
  • Phone: 702-290-8070
  • 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: