Provider Demographics
NPI:1275009862
Name:RALLINGS, GILTY DELA PENA (PCA)
Entity Type:Individual
Prefix:
First Name:GILTY
Middle Name:DELA PENA
Last Name:RALLINGS
Suffix:
Gender:F
Credentials:PCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5250 S RAINBOW BLVD UNIT 2119
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-0634
Mailing Address - Country:US
Mailing Address - Phone:702-960-2267
Mailing Address - Fax:
Practice Address - Street 1:5250 S RAINBOW BLVD UNIT 2119
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-0634
Practice Address - Country:US
Practice Address - Phone:702-960-2267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747P1801X
NV372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant