MEDICARE: MRS. TAMI J CALVANO

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
1	104100000X	Social Worker		NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184996373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TAMI J CALVANO

Provider Business Mailing Address
First Line	:	6145 SHAWNEE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-2551
Country	:	US
Telephone Number	:	702-236-5209
Fax Number	:

Provider Business Practice Location Address
First Line	:	580 W CHEYENNE AVE
Second Line	:	STE 70
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-3967
Country	:	US
Telephone Number	:	702-236-5209
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2012
Last Update Date	:	02/02/2012

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