1447606835 NPI number — MISS NYMPHA CABATU GARCIA

Table of content: MISS NYMPHA CABATU GARCIA (NPI 1447606835)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447606835 NPI number — MISS NYMPHA CABATU GARCIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARCIA
Provider First Name:
NYMPHA
Provider Middle Name:
CABATU
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GARCIA
Provider Other First Name:
NYMPHA
Provider Other Middle Name:
CABATU
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1447606835
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/11/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2310 PASEO DEL PRADO
Provider Second Line Business Mailing Address:
A203
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89102-4357
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-910-2333
Provider Business Mailing Address Fax Number:
702-910-4473

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2310 PASEO DEL PRADO
Provider Second Line Business Practice Location Address:
A203
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89102-4357
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-910-2333
Provider Business Practice Location Address Fax Number:
702-910-4473
Provider Enumeration Date:
05/04/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WH1000X , with the licence number:  NV20161219404 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 81-2497187 . This is a "LIBERTY CREEK HOSPICE, LLC" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".




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