MEDICARE: MRS. ANGELITTA WOMACK

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	3747A0650X	Attendant Care Provider

General Provider Information

NPI Number	:	1275462509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANGELITTA WOMACK

Provider Business Mailing Address
First Line	:	4235 N CHIEFTAIN ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-2665
Country	:	US
Telephone Number	:	562-481-4412
Fax Number	:	562-481-4412

Provider Business Practice Location Address
First Line	:	4235 N CHIEFTAIN ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-2665
Country	:	US
Telephone Number	:	562-481-4412
Fax Number	:	562-481-4412

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

Provider Enumeration Date	:	05/14/2026
Last Update Date	:	05/14/2026

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