Fani Su
Technician, Personal Care Attendant in North Las Vegas, NV. Individual provider (NPI-1).
NPI number1104570878
StatusActive
Last updated in NPPESFeb 10, 2022
Details
- NPI
- 1104570878
- Entity type
- Individual (NPI-1)
- Name
- Fani Su
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 10, 2022
- Certification date
- Feb 10, 2022
- Last updated
- Feb 10, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747P1801X | Technician, Personal Care Attendant | – | – | Yes |
Practice location
2415 Reynolds Ave Ste 100North Las Vegas, NV 89030-7279
Phone 702-822-1253
Mailing address
2415 Reynolds Ave Ste 100North Las Vegas, NV 89030-7279
Phone 702-822-1253
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