Provider Demographics
NPI:1740936244
Name:SWEET, MICHELLE ANTIONETTE
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:ANTIONETTE
Last Name:SWEET
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:MICHELLE
Other - Middle Name:THOMAS
Other - Last Name:SWEET
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2301 REDWOOD ST APT 1605
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-0834
Mailing Address - Country:US
Mailing Address - Phone:702-815-5304
Mailing Address - Fax:
Practice Address - Street 1:1771 E FLAMINGO RD STE 220A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-0850
Practice Address - Country:US
Practice Address - Phone:702-560-2192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide