Individual
DEORELLA ANSALE BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7036 PLEASANT VIEW AVE, LAS VEGAS, NV 89147-4520
(725) 203-2149
Mailing address
7036 PLEASANT VIEW AVE, LAS VEGAS, NV 89147-4520
(725) 203-2149
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/31/2023
Last updated
08/31/2023
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