Provider Demographics
NPI:1417560129
Name:GALVEZ, MYRNA MARQUEZ
Entity Type:Individual
Prefix:
First Name:MYRNA
Middle Name:MARQUEZ
Last Name:GALVEZ
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 1:5450 W SAHARA AVE STE 250A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-0383
Mailing Address - Country:US
Mailing Address - Phone:702-569-9616
Mailing Address - Fax:
Practice Address - Street 1:5450 W SAHARA AVE STE 250A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-0383
Practice Address - Country:US
Practice Address - Phone:702-569-9616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant