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Individual

MRS. GRACIE MAY HUNTER-GOODWIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4040 S EASTERN AVE, LAS VEGAS, NV 89119-0810
(702) 763-0300
(702) 463-0301
Mailing address
941 CHAPS CIR, HENDERSON, NV 89002-9517
(425) 999-0955

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN16279
NV

Other

Enumeration date
12/28/2023
Last updated
12/28/2023
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