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Individual

CHANELL FULTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2860 E FLAMINGO RD STE C, LAS VEGAS, NV 89121-5270
(702) 562-3355
Mailing address
6396 MCLEOD DR, SUITE 9, LAS VEGAS, NV 89120-4428
(702) 912-0600

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
372500000X
Chore Provider
372600000X
Adult Companion
3747A0650X
Attendant Care Provider
3747P1801X
Personal Care Attendant
Primary
376J00000X
Homemaker

Other

Enumeration date
08/22/2014
Last updated
07/16/2025
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