Individual
MICHELLE JASMINE BAEZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD, RPH
Contact information
Practice address
4191 DUSTIN AVE, LAS VEGAS, NV 89120
(480) 452-9256
Mailing address
4191 DUSTIN AVE, LAS VEGAS, NV 89120-2636
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19665
NV
Other
Enumeration date
11/06/2017
Last updated
11/06/2017
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