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NPI 1386478709

NPI 1386478709 : TI-ERAH NELSON : LAS VEGAS, NV

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General NPI Number Information
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    NPI Number           |    1386478709
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    Entity Type          |    Individual 
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    Provider Name        |    TI-ERAH NELSON
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/28/2024
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    Last Update Date     |    08/28/2024
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Provider Practice Location Address
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    Address Line         |    2001 S JONES BLVD STE A 
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    City                 |    LAS VEGAS
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    State                |    NV
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    Zip                  |    89146-3165
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    Country              |    US
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    Telephone            |    702-816-4639
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2001 S JONES BLVD STE A 
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    City                 |    LAS VEGAS
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    State                |    NV
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    Zip                  |    89146-3165
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    3747P1801X
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    Taxonomy Name        |    Personal Care Attendant
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    License Number       |    
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    License Number State |    
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