Individual
DESTINY VINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4701 LAWRENCE ST UNIT 1136, NORTH LAS VEGAS, NV 89081-4200
(818) 310-8878
Mailing address
4701 LAWRENCE ST UNIT 1136, NORTH LAS VEGAS, NV 89081-4200
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
895066
NV
Other
Enumeration date
05/07/2026
Last updated
05/07/2026
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