Provider Demographics
NPI:1477218428
Name:DUFFEY, PHYLAZHE JERMEAH (NA)
Entity Type:Individual
Prefix:
First Name:PHYLAZHE
Middle Name:JERMEAH
Last Name:DUFFEY
Suffix:
Gender:F
Credentials:NA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4221 KENSINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-5436
Mailing Address - Country:US
Mailing Address - Phone:725-200-9800
Mailing Address - Fax:
Practice Address - Street 1:4221 KENSINGTON WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-5436
Practice Address - Country:US
Practice Address - Phone:725-200-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-04
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide