NPI |
1013295500 |
The telephone number associated with the location address of the provider being identified. |
Entity Type Code |
1 |
The date the provider was assigned a unique identifier (assigned an NPI). |
Provider Last Name Legal Name |
EASTON |
The last name of the provider. If the provider is an individual, this is the legal name. |
Provider First Name |
JESSICA |
The first name of the provider, if the provider
is an individual. |
Provider Name Prefix Text |
MS. |
The name prefix or salutation of the provider
if the provider is an individual; for example, Mr., Mrs., or Corporal. |
Provider First Line Business Practice Location Address |
341 CHASTINE ST |
The middle name of the authorized official. |
Provider Business Practice Location Address City Name |
LAS VEGAS |
The title or position of the authorized official. |
Provider Business Practice Location Address State Name |
NV |
The 10-position telephone number of the authorized official. |
Provider Business Practice Location Address Postal Code |
891454761 |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Provider Business Practice Location Address Country Code If outside U S |
US |
|
Provider Business Practice Location Address Telephone Number |
7025265189 |
|
Provider Enumeration Date |
8/1/2011 |
|
Last Update Date |
8/1/2011 |
|
Provider Gender Code |
F |
The code designating the provider’s gender if the provider is a person. |
Healthcare Provider Taxonomy Code 1 |
225400000X |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
|
Is Sole Proprietor |
Y |
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No |