Basic Information
Provider Information
NPI: 1780322214
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MAYFIELD
FirstName: DIETRICH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
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Mailing Information
Address1: 8670 W CHEYENNE, SUITE 135
Address2: A HELPING HAND IN HOME HEALTH CARE
City: LAS VEGAS
State: NV
PostalCode: 89129
CountryCode: US
TelephoneNumber: 7028222600
FaxNumber: 7028221910
Practice Location
Address1: 8670 W CHEYENNE, SUITE 135
Address2: A HELPING HAND IN HOME HEALTH CARE
City: LAS VEGAS
State: NV
PostalCode: 89129
CountryCode: US
TelephoneNumber: 7028222600
FaxNumber: 7028221910
Other Information
ProviderEnumerationDate: 05/24/2022
LastUpdateDate: 05/24/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/24/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
374U00000X  Y Nursing Service Related ProvidersHome Health Aide 

No ID Information.


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