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General NPI Number Information
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NPI Number | 1720595374
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Entity Type | Individual
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Provider Name | CAMILLE TAIWO BS, MAT, MAEL
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Gender | Female
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Dates
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Enumeration Date | 01/04/2018
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Last Update Date | 05/14/2018
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Provider Practice Location Address
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Address Line | 1810 E SAHARA AVE STE 212
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City | LAS VEGAS
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State | NV
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Zip | 89104-3707
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Country | US
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Telephone | 702-772-9604
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Fax | 702-834-6890
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Provider Business Mailing Address
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Address Line | 1810 E SAHARA AVE STE 212
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City | LAS VEGAS
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State | NV
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Zip | 89104-3707
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Country | US
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Telephone | 888-601-6336
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Fax | 702-834-6890
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | NV
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