Basic Information
| Provider Information | |||||||||
| NPI: | 1154982270 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOLLAND | ||||||||
| FirstName: | ROCIO | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | |||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | GUERRERO VIRRUETA | ||||||||
| OtherFirstName: | ROCIO | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2860 E. FLAMINGO RD STE K | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89121 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7023185005 | ||||||||
| FaxNumber: | 7023185006 | ||||||||
| Practice Location | |||||||||
| Address1: | 2860 E. FLAMINGO RD STE K | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89121 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7023185005 | ||||||||
| FaxNumber: | 7023185006 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2019 | ||||||||
| LastUpdateDate: | 06/28/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 376J00000X | N | Nursing Service Related Providers | Homemaker | 3747P1801X | Y | Nursing Service Related Providers | Technician | Personal Care Attendant | 372500000X | N | Nursing Service Related Providers | Chore Provider | 372600000X | N | Nursing Service Related Providers | Adult Companion | 3747A0650X | N | Nursing Service Related Providers | Technician | Attendant Care Provider |
No ID Information.