Provider Demographics
NPI:1902465875
Name:COSIO, ESTELA
Entity Type:Individual
Prefix:MS
First Name:ESTELA
Middle Name:
Last Name:COSIO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ESTELA
Other - Middle Name:
Other - Last Name:COSIO MANRIQUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:535 S DECATUR BLVD
Mailing Address - Street 2:LAS VEGAS
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107
Mailing Address - Country:US
Mailing Address - Phone:702-562-2273
Mailing Address - Fax:702-227-8351
Practice Address - Street 1:535 S DECATUR BLVD
Practice Address - Street 2:LAS VEGAS
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107
Practice Address - Country:US
Practice Address - Phone:702-562-2273
Practice Address - Fax:702-227-8351
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No376J00000XNursing Service Related ProvidersHomemaker