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NPI Code Detail

MEDICARE: ELSIE GONZALES KAECKER

MEDICARE: ELSIE GONZALES KAECKER
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
1372500000XChore ProviderNV
2372600000XAdult CompanionNV
33747A0650XAttendant Care ProviderNV
4376J00000XHomemakerNV
53747P1801XPersonal Care AttendantNV

General Provider Information

NPI Number : 1508366097
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELSIE GONZALES KAECKER
Provider Business Mailing Address
First Line : 4050 PALOS VERDES ST APT 14
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-6956
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2001 S JONES BLVD STE F
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-3165
Country : US
Telephone Number : 702-202-3452
Fax Number : 702-982-8727
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2018
Last Update Date : 02/20/2018

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Directions to “ ELSIE GONZALES KAECKER ” Practice Location

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