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NPI Code Detail

MEDICARE: FRANCES BODDIE-SMALL

MEDICARE: FRANCES BODDIE-SMALL
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
1163WP0808XPsychiatric/Mental Health Registered NurseRN45395NV

General Provider Information

NPI Number : 1801062567
Entity Type Code : Individual
Provider Name (Legal Business Name) : FRANCES BODDIE-SMALL
Provider Business Mailing Address
First Line : 6161 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-1126
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1785 E SAHARA AVE STE 145
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-3713
Country : US
Telephone Number : 702-486-6400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2008
Last Update Date : 05/02/2008

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Directions to “ FRANCES BODDIE-SMALL ” Practice Location

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