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General NPI Number Information
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NPI Number | 1700430808
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Entity Type | Individual
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Provider Name | JAIMIENISHA LAFAY WHITE
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Gender | Female
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Dates
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Enumeration Date | 07/26/2019
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Last Update Date | 07/26/2019
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Provider Practice Location Address
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Address Line | 5600 E RUSSELL RD UNIT 1734
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City | LAS VEGAS
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State | NV
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Zip | 89122-8035
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Country | US
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Telephone | 323-801-3145
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Fax |
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Provider Business Mailing Address
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Address Line | 5600 E RUSSELL RD UNIT 1734
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City | LAS VEGAS
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State | NV
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Zip | 89122-8035
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Country | US
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Telephone | 323-801-3145
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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 | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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