Individual
ANGELICA CORDOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1517 E SAINT LOUIS AVE, LAS VEGAS, NV 89104-3551
(702) 576-3575
Mailing address
1517 E SAINT LOUIS AVE, LAS VEGAS, NV 89104-3551
(702) 576-3575
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2104713786
DRIVER LICENSE
NV
Enumeration date
02/01/2018
Last updated
02/01/2018
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