MEDICARE: ROBERTA BOATENG

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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1417802794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERTA BOATENG

Provider Business Mailing Address
First Line	:	2775 FREMONT ST UNIT 2044
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-2246
Country	:	US
Telephone Number	:	702-624-3822
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 N RAINBOW BLVD STE 28
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-1189
Country	:	US
Telephone Number	:	702-293-3888
Fax Number	:

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

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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Directions to “ ROBERTA BOATENG ” Practice Location

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