Provider Demographics
NPI:1942901632
Name:MALENDRES, MICHELLE DIANE
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:DIANE
Last Name:MALENDRES
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 1:153 W LAKE MEAD PKWY STE 1120
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-7045
Mailing Address - Country:US
Mailing Address - Phone:702-566-2433
Mailing Address - Fax:
Practice Address - Street 1:520 CRONY AVENUE
Practice Address - Street 2:HENDERSON
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89011-8901
Practice Address - Country:US
Practice Address - Phone:702-279-0803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant