Provider Demographics
NPI:1205177052
Name:FIERROS, NANCY LINDA
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:LINDA
Last Name:FIERROS
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 1:2815 W FORD AVE
Mailing Address - Street 2:#2125
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-6664
Mailing Address - Country:US
Mailing Address - Phone:702-776-6441
Mailing Address - Fax:702-369-5605
Practice Address - Street 1:2815 W FORD AVE
Practice Address - Street 2:#2125
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-6664
Practice Address - Country:US
Practice Address - Phone:702-776-6441
Practice Address - Fax:702-369-5605
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner