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NPI Code Detail

MEDICARE: GRACIELA HERRERA

MEDICARE:   GRACIELA  HERRERA
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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1720550973
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACIELA HERRERA
Provider Business Mailing Address
First Line : 6074 HIDDEN ROCK DR
Second Line :
City : N LAS VEGAS
State : NV
Zip : 89031-1607
Country : US
Telephone Number : 702-824-7026
Fax Number :
Provider Business Practice Location Address
First Line : 6074 HIDDEN ROCK DR
Second Line :
City : N LAS VEGAS
State : NV
Zip : 89031-1607
Country : US
Telephone Number : 702-824-7026
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2018
Last Update Date : 12/28/2018

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Directions to “ GRACIELA HERRERA ” Practice Location

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