MEDICARE: REBECCA JEAN CARNINE

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	372600000X	Adult Companion
2	3747A0650X	Attendant Care Provider
3	3747A0650X	Attendant Care Provider		NV
4	3747P1801X	Personal Care Attendant
5	374U00000X	Home Health Aide
6	376J00000X	Homemaker
7	3747A0650X	Attendant Care Provider	CNA015430	NV

General Provider Information

NPI Number	:	1790441095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA JEAN CARNINE

Provider Business Mailing Address
First Line	:	1832 LUNA VISTA PL
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-2084
Country	:	US
Telephone Number	:	702-813-2129
Fax Number	:

Provider Business Practice Location Address
First Line	:	1832 LUNA VISTA PL
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-2084
Country	:	US
Telephone Number	:	702-813-2129
Fax Number	:

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

Provider Enumeration Date	:	11/10/2021
Last Update Date	:	10/22/2024

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Directions to “ REBECCA JEAN CARNINE ” Practice Location

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