Provider Demographics
NPI:1982462859
Name:PRIMM, AMEARIAL
Entity Type:Individual
Prefix:
First Name:AMEARIAL
Middle Name:
Last Name:PRIMM
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 1:1601 S BOULDER HWY APT 2303
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-8508
Mailing Address - Country:US
Mailing Address - Phone:601-493-0257
Mailing Address - Fax:
Practice Address - Street 1:153 W LAKE MEAD PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-7044
Practice Address - Country:US
Practice Address - Phone:702-566-2433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant