Provider Demographics
NPI:1083260046
Name:ROSAS VARGAS, ARACELI
Entity Type:Individual
Prefix:
First Name:ARACELI
Middle Name:
Last Name:ROSAS VARGAS
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 1:5160 S. EASTERN AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119
Mailing Address - Country:US
Mailing Address - Phone:702-798-0553
Mailing Address - Fax:702-798-0556
Practice Address - Street 1:5160 S. EASTERN AVE
Practice Address - Street 2:SUITE E
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119
Practice Address - Country:US
Practice Address - Phone:702-798-0553
Practice Address - Fax:702-798-0556
Is Sole Proprietor?:No
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant