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NPI Code Detail

MEDICARE: SAMMY WALLS

MEDICARE:   SAMMY  WALLS
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
1374U00000XHome Health Aide1306384219NV

Other Identifiers

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

General Provider Information

NPI Number : 1396697439
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMMY WALLS
Provider Business Mailing Address
First Line : 3435 W CRAIG RD STE A
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-5116
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3435 W CRAIG RD STE A
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-5116
Country : US
Telephone Number : 702-929-3297
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2026
Last Update Date : 02/11/2026

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Directions to “ SAMMY WALLS ” Practice Location

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