MEDICARE: KYRA HENRY

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	374J00000X	Doula

General Provider Information

NPI Number	:	1386429595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYRA HENRY

Provider Business Mailing Address
First Line	:	8626 KENNEDY HEIGHTS CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-1792
Country	:	US
Telephone Number	:	702-686-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2837 CHANNEL BAY DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-7205
Country	:	US
Telephone Number	:	702-686-0000
Fax Number	:

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

Provider Enumeration Date	:	08/28/2023
Last Update Date	:	11/16/2024

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Directions to “ KYRA HENRY ” Practice Location

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