MEDICARE: MISS KOKISHA SHADAY HARDY

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	374700000X	Technician

General Provider Information

NPI Number	:	1265012751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS KOKISHA SHADAY HARDY

Provider Business Mailing Address
First Line	:	2860 E FLAMINGO RD STE C
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5270
Country	:	US
Telephone Number	:	702-562-3355
Fax Number	:	702-369-8284

Provider Business Practice Location Address
First Line	:	4701 E SAHARA AVE APT 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-6342
Country	:	US
Telephone Number	:	909-566-6267
Fax Number	:

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

Provider Enumeration Date	:	04/09/2021
Last Update Date	:	04/09/2021

Similar Medicare Providers

1609383991 — MAXCARE MEDICAL CENTER (CHUA) PLLC
Practice Location Address:

6342 TOMAHAWK MILL CT
LAS VEGAS, NV
89139-7231

Practice Phone: 310-985-1753
Practice Fax:

1417812793 — MICHELLE SHREVES
Practice Location Address:

8939 DOVE COVE DR
LAS VEGAS, NV
89129-6342

Practice Phone: 702-540-6194
Practice Fax:

1730988213 — TAMARA ELIZABETH DAVIS
Practice Location Address:

1253 S KIRKWOOD RD
KIRKWOOD, MO
63122-7224

Practice Phone: 314-821-5300
Practice Fax:

1457471443 — JAIME BLANK GERBER M.D.
Practice Location Address:

2217 PARADISE RD STE A
LAS VEGAS, NV
89104-2514

Practice Phone: 888-224-0804
Practice Fax:

1538011820 — BERENICE SOLEDAD ROSALES REYES
Practice Location Address:

1640 E SAHARA AVE STE E
LAS VEGAS, NV
89104-3491

Practice Phone: 702-822-2655
Practice Fax:

1346192465 — ARELI AVILA MARTINEZ
Practice Location Address:

2150 S EASTERN AVE
LAS VEGAS, NV
89104-4109

Practice Phone: 702-207-0842
Practice Fax: 702-207-0357

Directions to “ MISS KOKISHA SHADAY HARDY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.