Shantel Sullivan
Technician, Personal Care Attendant in Las Vegas, NV. Individual provider (NPI-1).
NPI number1861997124
StatusActive
Last updated in NPPESMar 28, 2018
Details
- NPI
- 1861997124
- Entity type
- Individual (NPI-1)
- Name
- Shantel Sullivan
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 28, 2018
- Last updated
- Mar 28, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747P1801X | Technician, Personal Care Attendant | – | – | Yes |
Practice location
1312 S 8th StLas Vegas, NV 89104-1638
Phone 702-385-0920
Mailing address
1312 S 8th StLas Vegas, NV 89104-1638
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