MEDICARE: ROWENA SANTOS

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	:	1588290878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROWENA SANTOS

Provider Business Mailing Address
First Line	:	1005 TERMINAL WAY
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89502-2120
Country	:	US
Telephone Number	:	877-786-4999
Fax Number	:

Provider Business Practice Location Address
First Line	:	8212 RUBY MOUNTAIN WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-8251
Country	:	US
Telephone Number	:	702-919-9854
Fax Number	:

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

Provider Enumeration Date	:	03/18/2020
Last Update Date	:	03/18/2020

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Directions to “ ROWENA SANTOS ” Practice Location

Language	Start Address	Practice Location

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