Individual
ANTONIQUE EDDINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1951 STELLA LAKE ST STE 36, LAS VEGAS, NV 89106-2144
(702) 595-8309
Mailing address
1951 STELLA LAKE ST STE 36, LAS VEGAS, NV 89106-2144
(702) 595-8309
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F7960642
IDENTIFICATION CARD
CA
Enumeration date
09/14/2022
Last updated
09/14/2022
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