Individual
TAMMY A MACANAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PRSS-S
Contact information
Practice address
4800 ALPINE PL STE 12, LAS VEGAS, NV 89107-4086
(702) 257-8199
(702) 257-8299
Mailing address
4800 ALPINE PL STE 12, LAS VEGAS, NV 89107-4086
(702) 257-8199
(702) 257-8299
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
PRSS-SUP-5081
NV
175T00000X
Peer Specialist
Primary
—
NV
Other
Enumeration date
08/29/2024
Last updated
03/04/2026
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