MEDICARE: DENISE LUCIANO

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	3747P1801X	Personal Care Attendant		NV

General Provider Information

NPI Number	:	1891348504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE LUCIANO

Provider Business Mailing Address
First Line	:	153 W LAKE MEAD PKWY STE 1220
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89015-7046
Country	:	US
Telephone Number	:	702-566-0665
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 E LAKE MEAD PKWY APT 2114
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89015-6423
Country	:	US
Telephone Number	:	224-200-7145
Fax Number	:

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

Provider Enumeration Date	:	07/22/2019
Last Update Date	:	07/22/2019

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Directions to “ DENISE LUCIANO ” Practice Location

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