Basic Information
| Provider Information | |||||||||
| NPI: | 1972865996 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ENGLAND | ||||||||
| FirstName: | BEAU | ||||||||
| MiddleName: | T | ||||||||
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| Credential: | AU.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10470 W CHEYENNE AVE STE 120 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891298733 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022402059 | ||||||||
| FaxNumber: | 7022402065 | ||||||||
| Practice Location | |||||||||
| Address1: | 5920 S RAINBOW BLVD | ||||||||
| Address2: | SUITE 9 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891184208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7023623138 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2012 | ||||||||
| LastUpdateDate: | 12/23/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237600000X | A-242 | NV | N | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | 231H00000X | A-242 | NV | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.