Larry Russell
Technician, Personal Care Attendant in Las Vegas, NV. Individual provider (NPI-1).
NPI number1164079646
StatusActive
Last updated in NPPESAug 20, 2019
Details
- NPI
- 1164079646
- Entity type
- Individual (NPI-1)
- Name
- Larry Russell
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 20, 2019
- Last updated
- Aug 20, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747P1801X | Technician, Personal Care Attendant | – | – | Yes |
| 372500000X | Chore Provider | – | – | |
| 372600000X | Adult Companion | – | – | |
| 3747A0650X | Technician, Attendant Care Provider | – | – | |
| 376J00000X | Homemaker | – | – |
Practice location
6725 S Eastern Ave Ste 1Las Vegas, NV 89119-3949
Phone 702-331-6200
Mailing address
6725 S Eastern Ave Ste 1Las Vegas, NV 89119-3949
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