Individual
LISA BETH MAYFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7653 FABLED FILIGREE ST, LAS VEGAS, NV 89149-0435
(702) 789-8522
Mailing address
7653 FABLED FILIGREE ST, LAS VEGAS, NV 89149-0435
(702) 789-8522
Taxonomy
Speciality
Code
Description
License number
State
332U00000X
Home Delivered Meals
Primary
NV20121065010
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NV20121065010
PROFESSIONAL LICENSE NUMBER
NV
Enumeration date
02/08/2012
Last updated
02/08/2012
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