Individual
FATU KANNEH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3367 REKA ST, LAS VEGAS, NV 89121-4227
(774) 329-6072
Mailing address
3367 REKA ST, LAS VEGAS, NV 89121-4227
(774) 329-6072
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CNA037026
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1606144806
—
NV
Enumeration date
05/22/2019
Last updated
05/22/2019
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