Provider Demographics
NPI:1538955224
Name:GALIARDI, KESHA
Entity type:Individual
Prefix:
First Name:KESHA
Middle Name:
Last Name:GALIARDI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1047 SWEEPING VINE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-6346
Mailing Address - Country:US
Mailing Address - Phone:702-762-2664
Mailing Address - Fax:
Practice Address - Street 1:4225 S EASTERN AVE STE 8
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5485
Practice Address - Country:US
Practice Address - Phone:702-201-1956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV81127-AL-0246RP1900X
NV1133621374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy