Provider Demographics
NPI:1255177655
Name:MOU, ZHENG POLY
Entity type:Individual
Prefix:
First Name:ZHENG
Middle Name:POLY
Last Name:MOU
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 1:3422 RAWHIDE ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-2031
Mailing Address - Country:US
Mailing Address - Phone:702-758-3608
Mailing Address - Fax:
Practice Address - Street 1:3422 RAWHIDE ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-2031
Practice Address - Country:US
Practice Address - Phone:702-758-3608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-04
Last Update Date:2024-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion