Individual
CARA BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2560 E SUNSET RD STE 106, LAS VEGAS, NV 89120-3517
(702) 202-0552
(702) 224-2157
Mailing address
1004 PROVIDENCE LN, BOULDER CITY, NV 89005-4204
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
1704223380
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1704223380
DRIVER LICENSE
NV
Enumeration date
10/01/2019
Last updated
11/27/2023
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