Provider Demographics
NPI:1922724889
Name:MCNAIR, TISHA
Entity Type:Individual
Prefix:
First Name:TISHA
Middle Name:
Last Name:MCNAIR
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 1:5609 PELLA POMPANO ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-3697
Mailing Address - Country:US
Mailing Address - Phone:702-778-7440
Mailing Address - Fax:702-463-7527
Practice Address - Street 1:5609 PELLA POMPANO ST
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-3697
Practice Address - Country:US
Practice Address - Phone:702-778-7440
Practice Address - Fax:702-463-7527
Is Sole Proprietor?:No
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant