Pulliam, Diana

Pulliam, Diana is an individual health care provider with primary practice located at 3455 W Craig Rd Ste B , N Las Vegas NV 89032-5119. She recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as her primary health care specialty. Pulliam, Diana can be contacted via phone (702) 776-7772.

Contact Information

Primary practice address
3455 W Craig Rd Ste B N Las Vegas NV 89032-5119
Phone: (702) 776-7772
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Community Health Worker 172V00000X

Profile Details

NPI number 1215359914
LBN Legal business name Pulliam, Diana
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 14th, 2014
Last updated Jan 14th, 2014 - about 11 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215359914 NPPES
Nevada MEDICAID 1811325095

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