Laquann Wallace
Individual provider Active NPI Personal Care Attendant · Las Vegas, NV
NPI 1124580873 · NPPES record last updated Jan 10, 2022
Key facts
- NPI
- 1124580873
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- 2235 E Flamingo Rd Ste 130
Las Vegas, NV 89119-5189 - Phone
- (702) 890-0405
- NPI assigned
- Apr 2, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Starlight Home Care, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Yes |
Addresses
Primary practice location
2235 E Flamingo Rd Ste 130
Las Vegas, NV 89119-5189
Mailing address
2235 E Flamingo Rd Ste 130
Las Vegas, NV 89119-5189
Phone (702) 890-0405
Other providers in Las Vegas, NV
- Jerrilyn Wallace
- Jessica Wallace
- Kelly Nekay Wallace
- Kimberly Wallace
- La Shaunda Wallace
- Marie L. Wallace
- Melanie Rose Williams Wallace
- Misty Lee Wallace
- Nicolas Wallace
- Nolan Michael Wallace
All providers in Las Vegas, NV · Personal Care Attendant in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.