Individual
YESHAREG YOHANNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3601 EL CONLON AVE, LAS VEGAS, NV 89102-5858
(702) 510-7145
Mailing address
580 SICILIANO ST, LAS VEGAS, NV 89138-7515
(702) 788-5892
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000619501
NPI
—
Enumeration date
08/19/2019
Last updated
08/19/2019
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