Provider Demographics
NPI:1457613663
Name:GARCIA, MARJORIE ANN
Entity type:Individual
Prefix:
First Name:MARJORIE
Middle Name:ANN
Last Name:GARCIA
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 1:7943 DEXTER FALLS ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-3726
Mailing Address - Country:US
Mailing Address - Phone:570-872-3887
Mailing Address - Fax:
Practice Address - Street 1:2770 S MARYLAND PKWY STE 310
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109
Practice Address - Country:US
Practice Address - Phone:702-240-3800
Practice Address - Fax:702-240-3001
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-13
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant