Individual
CASEY FITZPATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6615 S EASTERN AVE STE 104, LAS VEGAS, NV 89119-3926
(702) 722-6200
(702) 722-6202
Mailing address
2380 TOUGH GIRL RD, PAHRUMP, NV 89060-3103
(702) 863-9329
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
251E00000X
HOME HEALTH
—
Enumeration date
10/16/2019
Last updated
10/16/2019
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