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NPI Code Detail

MEDICARE: ANDREA SMITH

MEDICARE: ANDREA SMITH
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 : 1104781954
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA SMITH
Provider Business Mailing Address
First Line : 1055 E FLAMINGO RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-7441
Country : US
Telephone Number : 619-713-3899
Fax Number :
Provider Business Practice Location Address
First Line : 3930 HOWARD HUGHES PKWY STE 300
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-0946
Country : US
Telephone Number : 702-560-2192
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2025
Last Update Date : 12/23/2025

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Directions to “ ANDREA SMITH ” Practice Location

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