Provider Demographics
NPI:1245886035
Name:CAMARENA ZUNIGA, EDITH
Entity type:Individual
Prefix:
First Name:EDITH
Middle Name:
Last Name:CAMARENA ZUNIGA
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 1:410 S RAMPART BLVD
Mailing Address - Street 2:SUITE 347
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145
Mailing Address - Country:US
Mailing Address - Phone:725-251-3737
Mailing Address - Fax:725-251-5797
Practice Address - Street 1:410 S RAMPART BLVD
Practice Address - Street 2:SUITE 347
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145
Practice Address - Country:US
Practice Address - Phone:725-251-3737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV372500000X, 372600000X, 3747A0650X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider