MEDICARE: SONYA WILBON CERTIFIED NURSE ASSI

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	374U00000X	Home Health Aide	877892	NV

General Provider Information

NPI Number	:	1598643660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONYA WILBON CERTIFIED NURSE ASSI

Provider Business Mailing Address
First Line	:	45 MALEENA MESA ST APT 1312
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-8141
Country	:	US
Telephone Number	:	810-394-6171
Fax Number	:

Provider Business Practice Location Address
First Line	:	6151 VEGAS DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-2593
Country	:	US
Telephone Number	:	702-648-4900
Fax Number	:

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

Provider Enumeration Date	:	08/26/2025
Last Update Date	:	08/26/2025

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