LAQUANN WALLACE (NPI# 1124580873) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124580873 |
| Entity Type | Individual |
| Full Name | LAQUANN WALLACE |
| Practice Address |
2235 E Flamingo Rd Ste 130 Las Vegas NV 89119-5189 |
| Practice Telephone | 7028900405 |
| Mailing Telephone | 7028900405 |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2019-04-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers |
| Street Address |
2235 E FLAMINGO RD STE 130 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89119-5189 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356830798 | A Starlight Home Care, LLC | Home Health | 2235 E Flamingo Rd Ste 130, Las Vegas, NV 89119 | 2018-05-01 |
| 1255984670 | Sherree Annette Russell | Chore Provider | 2235 E Flamingo Rd Ste 130, Las Vegas, NV 89119-5189 | 2019-07-24 |
| 1144873829 | Michael Sean Ozenne | Chore Provider | 2235 E Flamingo Rd Ste 130, Las Vegas, NV 89119-5189 | 2019-07-22 |
| 1760034763 | Elizabeth Reeder | Chore Provider | 2235 E Flamingo Rd Ste 130, Las Vegas, NV 89119-5189 | 2019-07-10 |
| 1609428895 | John Leland Monson | Chore Provider | 2235 E Flamingo Rd Ste 130, Las Vegas, NV 89119-5189 | 2019-07-09 |
| 1598327421 | Brandon Michael Williams | Chore Provider | 2235 E Flamingo Rd Ste 130, Las Vegas, NV 89119-5189 | 2019-07-01 |
| 1033771951 | Charmaine Denise Beverly | Adult Companion | 2235 E Flamingo Rd Ste 130, Las Vegas, NV 89119-5189 | 2019-07-01 |
| 1578125498 | Linda Dee Obeso | Chore Provider | 2235 E Flamingo Rd Ste 130, Las Vegas, NV 89119-5189 | 2019-07-01 |
| 1245792993 | Stella Sarkisyan | Technician | 2235 E Flamingo Rd Ste 130, Las Vegas, NV 89119-5189 | 2019-04-02 |
| 1063974715 | Daulton Mccalla | Technician | 2235 E Flamingo Rd Ste 130, Las Vegas, NV 89119-5189 | 2019-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669089298 | Jennifer Chavon Cruse | Technician | [email protected], 1775 East Tropicana Avenue 16-b, Las Vegas, NV 89119 | 2020-09-28 |
| 1063024214 | Rosa Isela Martinez Gonzalez | Technician | 4324 S. Eastern Ave. Ste. B, Las Vegas, NV 89119 | 2020-08-19 |
| 1720697980 | Christian Scott | Social Worker | 4055 Spencer St #118, Las Vegas, NV 89119 | 2020-07-23 |
| 1245867159 | Starfruit Holdings, LLC | Skilled Nursing Facility | 4375 S Eastern Ave, Paradise, NV 89119 | 2020-03-23 |
| 1215562376 | Phyllis Eberechukwu Hunt | Adult Companion | 5160 Tamarus St Appt 17, Las Vegas, NV 89119 | 2020-03-10 |
| 1841832581 | Legna Carrillo | Adult Companion | 4325 South Bruce St Appt 63, Las Vegas, NV 89119 | 2019-10-15 |
| 1104468339 | Alma Leticia Salazar | Home Health Aide | Safe At Home, LLC, 1775 E. Tropicana Ave. Suit 16-b, Las Vegas, NV 89119 | 2019-10-09 |
| 1083260046 | Araceli Rosas Vargas | Technician | 5160 S. Eastern Ave, Suite E, Las Vegas, NV 89119 | 2019-08-15 |
| 1376197707 | Bristure Clayton | Technician | Safe At Home LLC, 1775 E Tropicana Ave Ste 16, Las Vegas, NV 89119 | 2019-07-24 |
| 1457904534 | Carmen Laura Gonzalez Valenzuela | Chore Provider | 6725-1 S. Eastern Ave, Las Vegas, NV 89119 | 2019-07-18 |
| Find all providers in zip 89119 | ||||
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396628 | Jill Azevedo | Technician | 6300 Black Mesa Ct, Las Vegas, NV 89142-7919 | 2020-11-06 |
| 1396346409 | Johanna Dwyer | Technician | 5755 E Lake Mead Blvd Apt D, Las Vegas, NV 89156-6859 | 2020-11-04 |
| 1063013274 | Lloyd Major | Technician | 3830 University Center Dr Apt 318, Las Vegas, NV 89119-7420 | 2020-11-04 |
| 1861093239 | Raiquave Morgan | Technician | 5256 Tamarus St Apt B, Las Vegas, NV 89119-5047 | 2020-11-03 |
| 1669073250 | Chrissy Bowser | Technician | 3355 Spg Mnt Rd Ste 67, Las Vegas, NV 89102-8633 | 2020-11-02 |
| 1235739392 | Maxima Del Carmen Garcia | Technician | 3580 E Alexander Rd Apt 2016, Las Vegas, NV 89115 | 2020-10-28 |
| 1427657196 | Hector Querubin | Technician | 5400 S Maryland Pkwy Apt 165, Las Vegas, NV 89119-2642 | 2020-10-22 |
| 1043819063 | Ma Guadalupe Ramos Michel | Technician | 2415 Reynolds Ave #101, Las Vegas, NV 89030 | 2020-10-21 |
| 1881293777 | Miguel Angel Umpierre | Technician | 9889 Overlook Ridge Ave, Las Vegas, NV 89148 | 2020-10-21 |
| 1356940654 | Shannon Gordon | Technician | 1224 W Lake Mead Blvd, Las Vegas, NV 89106-2415 | 2020-10-19 |
| Find all providers in LAS VEGAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.