Broades, Calandra Tahnee
Broades, Calandra Tahnee is an sole proprietor health care provider with primary practice located at 5067 Madre Mesa Dr Apt 2015 , Las Vegas NV 89108-3592. She recently has only one registered license in Suppliers / Prosthetic/Orthotic Supplier, which is considered as her primary health care specialty. Broades, Calandra Tahnee can be contacted via phone (903) 280-5025.Contact Information
Primary practice address
5067 Madre Mesa Dr Apt 2015
Las Vegas NV 89108-3592
Phone: (903) 280-5025
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Prosthetic/Orthotic Supplier | 335E00000X | NV2022642425 | Nevada |
Profile Details
| NPI number | 1477266849 |
|---|---|
| LBN Legal business name | Broades, Calandra Tahnee |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 2nd, 2023 |
| Last updated | Jan 2nd, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477266849 | NPPES |
| Nevada | MEDICAID | 884365835 |
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