MEDICARE: NAFISA DANIELS

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	373H00000X	Day Training/Habilitation Specialist
2	172V00000X	Community Health Worker		NV

General Provider Information

NPI Number	:	1265082952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAFISA DANIELS

Provider Business Mailing Address
First Line	:	551 DUTCHMAN AVE
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89011-4316
Country	:	US
Telephone Number	:	702-715-7295
Fax Number	:

Provider Business Practice Location Address
First Line	:	551 DUTCHMAN AVE
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89011-4316
Country	:	US
Telephone Number	:	702-715-7295
Fax Number	:

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

Provider Enumeration Date	:	09/16/2019
Last Update Date	:	09/27/2020

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Directions to “ NAFISA DANIELS ” Practice Location

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