Provider Demographics
NPI:1073285771
Name:BISONA, NANCY
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:BISONA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4525 S SANDHILL RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-5954
Mailing Address - Country:US
Mailing Address - Phone:702-954-4087
Mailing Address - Fax:702-915-7483
Practice Address - Street 1:7836 APACHE CLIFF ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-3010
Practice Address - Country:US
Practice Address - Phone:702-985-5602
Practice Address - Fax:702-915-7483
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care