Healthcare Provider Details

I. General information

NPI: 1750677639
Provider Name (Legal Business Name): NANCY GILES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2011
Last Update Date: 07/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5101 TROPICAL RAIN ST
NORTH LAS VEGAS NV
89031-0991
US

IV. Provider business mailing address

5101 TROPICAL RAIN ST
NORTH LAS VEGAS NV
89031-0991
US

V. Phone/Fax

Practice location:
  • Phone: 208-659-9132
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: