Provider Demographics
NPI:1598257917
Name:ABELARDO, LOLITA
Entity Type:Individual
Prefix:
First Name:LOLITA
Middle Name:
Last Name:ABELARDO
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 1:1701 N GREEN VALLEY PKWY STE 9A
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-5991
Mailing Address - Country:US
Mailing Address - Phone:702-407-1100
Mailing Address - Fax:702-614-4783
Practice Address - Street 1:1701 N GREEN VALLEY PKWY STE 9A
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074
Practice Address - Country:US
Practice Address - Phone:702-407-1100
Practice Address - Fax:702-614-4783
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-01
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide