Provider Demographics
NPI:1548891682
Name:UYLOAN, MARIE STEPHANIE DIAZ
Entity type:Individual
Prefix:
First Name:MARIE STEPHANIE
Middle Name:DIAZ
Last Name:UYLOAN
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 1:1771 E FLAMINGO RD STE 230A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-0851
Mailing Address - Country:US
Mailing Address - Phone:818-932-4224
Mailing Address - Fax:
Practice Address - Street 1:1771 E FLAMINGO RD STE 230A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-0851
Practice Address - Country:US
Practice Address - Phone:702-476-2840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant