Individual
ANTIONETTE BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4080 E LAKE MEAD BLVD STE B-111, LAS VEGAS, NV 89115-6466
(702) 629-8226
Mailing address
4080 E LAKE MEAD BLVD STE B-111, LAS VEGAS, NV 89115-6466
(702) 629-8226
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7029868788
—
NV
Enumeration date
07/29/2019
Last updated
07/29/2019
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