MEDICARE: NANCY MONTES CASTANEDA

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	376J00000X	Homemaker
2	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1962139816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY MONTES CASTANEDA

Provider Business Mailing Address
First Line	:	3468 E SAHARA AVE STE 165
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-4827
Country	:	US
Telephone Number	:	702-201-2579
Fax Number	:

Provider Business Practice Location Address
First Line	:	3868 E SAHARA AVE
Second Line	:	SUITE 165
City	:	LAS VEGAS
State	:	NV
Zip	:	89104
Country	:	US
Telephone Number	:	702-207-0842
Fax Number	:

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

Provider Enumeration Date	:	08/02/2022
Last Update Date	:	08/02/2022

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