Provider Demographics
NPI:1679127096
Name:NUNEZ, WILMA GUADALUPE
Entity Type:Individual
Prefix:MS
First Name:WILMA
Middle Name:GUADALUPE
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:WILMA
Other - Middle Name:GUADALUPE
Other - Last Name:NUNEZ CABRERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2860 EAST FLAMINGO
Mailing Address - Street 2:SUITE C
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121
Mailing Address - Country:US
Mailing Address - Phone:702-562-3355
Mailing Address - Fax:702-369-8284
Practice Address - Street 1:2860 EAST FLAMINGO
Practice Address - Street 2:SUITE C
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121
Practice Address - Country:US
Practice Address - Phone:702-562-3355
Practice Address - Fax:702-369-8284
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No376J00000XNursing Service Related ProvidersHomemaker