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Individual

ANA MARIA MESA DE LARA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4550 W OAKEY BLVD STE O, LAS VEGAS, NV 89102-1581
(702) 861-0238
Mailing address
1512 PADRE BAY DR, LAS VEGAS, NV 89108-1828

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
376J00000X
Homemaker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300912382
NV
Enumeration date
09/15/2021
Last updated
09/15/2021
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