Individual
TANIKA LAKEISHA WILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 N RAINBOW BLVD STE 300, LAS VEGAS, NV 89107-1061
(702) 448-8145
Mailing address
500 N RAINBOW BLVD STE 300, LAS VEGAS, NV 89107-1061
(702) 448-8145
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W420-812-92-674-0
TRICARE
FL
Enumeration date
08/18/2020
Last updated
08/18/2020
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