MEDICARE: NIGHTINGALE HOME HEALTHCARE OF NEVADA, INC

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	251E00000X	Home Health Agency	3890HHA5	NV

General Provider Information

NPI Number	:	1659436046
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NIGHTINGALE HOME HEALTHCARE OF NEVADA, INC

Provider Business Mailing Address
First Line	:	PO BOX 1710
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46082-1710
Country	:	US
Telephone Number	:	866-334-7777
Fax Number	:	317-569-1403

Provider Business Practice Location Address
First Line	:	6236 W DESERT INN RD STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-6612
Country	:	US
Telephone Number	:	702-240-9002
Fax Number	:	702-240-9008

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DEV BRAR
Credential	:	MD
Telephone Number	:	317-334-7777

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	06/15/2020

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