Provider Demographics
NPI:1518574755
Name:ARCIOSA, HERMIE
Entity Type:Individual
Prefix:
First Name:HERMIE
Middle Name:
Last Name:ARCIOSA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8006 ARCADIAN LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-3700
Mailing Address - Country:US
Mailing Address - Phone:702-808-2524
Mailing Address - Fax:
Practice Address - Street 1:1064 E SAHARA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3220
Practice Address - Country:US
Practice Address - Phone:725-244-4182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide