Basic Information
Provider Information
NPI: 1861973646
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZARGARYAN
FirstName: KARINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7701 W WIGWAM AVE
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 891135406
CountryCode: US
TelephoneNumber: 7023277017
FaxNumber:  
Practice Location
Address1: 160 E HORIZON DR STE A
Address2:  
City: HENDERSON
State: NV
PostalCode: 890157934
CountryCode: US
TelephoneNumber: 7026443600
FaxNumber: 7027195665
Other Information
ProviderEnumerationDate: 08/28/2018
LastUpdateDate: 08/28/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
372600000X NVN Nursing Service Related ProvidersAdult Companion 
3747A0650X NVN Nursing Service Related ProvidersTechnicianAttendant Care Provider
3747P1801X NVY Nursing Service Related ProvidersTechnicianPersonal Care Attendant
372500000X NVN Nursing Service Related ProvidersChore Provider 

No ID Information.


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