Tyler Ross Andrade
Individual provider Active NPI Personal Care Attendant · Las Vegas, NV
NPI 1679040505 · NPPES record last updated Oct 29, 2018
Key facts
- NPI
- 1679040505
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- 3970 Shimmering Plains St
Las Vegas, NV 89129-4822 - Phone
- (857) 880-7165
- NPI assigned
- Oct 29, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | NV | Yes |
Addresses
Primary practice location
3970 Shimmering Plains St
Las Vegas, NV 89129-4822
Mailing address
3970 Shimmering Plains St
Las Vegas, NV 89129-4822
Phone (857) 880-7165
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00002289986 | Medicaid | NV |
Other providers in Las Vegas, NV
- Lisa Andrade
- Maybeth Andrade
- Natalie Marie Andrade
- Sandra Elizabeth Andrade
- Stephanie Andrade
- Jeannette Philippe Andraos
- Andrea Dempsey MD PC
- Andrea E Pernell MD PC
- Dale Lynn Andreason
- Maria Andrei
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 Oct 29, 2018. 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.