Provider Demographics
NPI:1205395795
Name:BYERS, PORSCHE
Entity Type:Individual
Prefix:
First Name:PORSCHE
Middle Name:
Last Name:BYERS
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 1:4738 CONVAIRE AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89115-7276
Mailing Address - Country:US
Mailing Address - Phone:323-202-6583
Mailing Address - Fax:
Practice Address - Street 1:4738 CONVAIRE AVE APT 3
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89115-7276
Practice Address - Country:US
Practice Address - Phone:323-202-6583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide