Provider Demographics
NPI:1790373108
Name:HURESKIN, CHARDAE (COSMETOLOGIST)
Entity Type:Individual
Prefix:
First Name:CHARDAE
Middle Name:
Last Name:HURESKIN
Suffix:
Gender:F
Credentials:COSMETOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8905 GOLDSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89143-1396
Mailing Address - Country:US
Mailing Address - Phone:702-767-6164
Mailing Address - Fax:
Practice Address - Street 1:1520 W SUNSET RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-6848
Practice Address - Country:US
Practice Address - Phone:702-767-6164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-02
Last Update Date:2021-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist