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General NPI Number Information
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NPI Number | 1861026403
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Entity Type | Individual
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Provider Name | ROSHONDA JANEANE MAYFIELD
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Gender | Female
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Dates
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Enumeration Date | 02/22/2020
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Last Update Date | 05/19/2021
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Provider Practice Location Address
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Address Line | 2675 NORTH DECATUR BOULEVARD #572237
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City | LAS VEGAS
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State | NV
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Zip | 89108-8910
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Country | US
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Telephone | 702-808-2565
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Fax | 702-478-6932
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Provider Business Mailing Address
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Address Line | PO BOX 572237
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City | LAS VEGAS
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State | NV
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Zip | 89157-2237
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Country | US
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Telephone | 702-808-2656
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Fax | 702-478-6932
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | NV20212085386
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License Number State | NV
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