Provider Demographics
NPI:1720633480
Name:HIRA, LAKHVIR KAUR
Entity Type:Individual
Prefix:
First Name:LAKHVIR
Middle Name:KAUR
Last Name:HIRA
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 1:7898 CORONADO ISLAND ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-6299
Mailing Address - Country:US
Mailing Address - Phone:702-349-5721
Mailing Address - Fax:
Practice Address - Street 1:6615 S EASTERN AVE STE 104
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-3926
Practice Address - Country:US
Practice Address - Phone:702-722-6200
Practice Address - Fax:702-722-6202
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV251E00000XOtherHOME HEALTH