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NPI Code Detail

MEDICARE: REGINALD UPSHAW

MEDICARE:   REGINALD  UPSHAW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1033956891
Entity Type Code : Individual
Provider Name (Legal Business Name) : REGINALD UPSHAW
Provider Business Mailing Address
First Line : 8850 ECHELON POINT DR APT 174
Second Line :
City : LAS VEGAS
State : NV
Zip : 89149-4889
Country : US
Telephone Number : 702-886-0401
Fax Number :
Provider Business Practice Location Address
First Line : 8850 ECHELON POINT DR APT 174
Second Line :
City : LAS VEGAS
State : NV
Zip : 89149-4889
Country : US
Telephone Number : 702-886-0401
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2024
Last Update Date : 07/10/2024

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Directions to “ REGINALD UPSHAW ” Practice Location

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