Provider Demographics
NPI:1184449753
Name:PETERS, RASHAWN
Entity type:Individual
Prefix:
First Name:RASHAWN
Middle Name:
Last Name:PETERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8360 MONTECITO POINTE DR APT 1065
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-4783
Mailing Address - Country:US
Mailing Address - Phone:214-881-2096
Mailing Address - Fax:
Practice Address - Street 1:8360 MONTECITO POINTE DR APT 1065
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-4783
Practice Address - Country:US
Practice Address - Phone:214-881-2096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide