Provider Demographics
NPI:1639965866
Name:MARTINEZ-SHTAVINSKI, ELIANE
Entity type:Individual
Prefix:
First Name:ELIANE
Middle Name:
Last Name:MARTINEZ-SHTAVINSKI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5081 E HACIENDA AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89122-6940
Mailing Address - Country:US
Mailing Address - Phone:725-249-3611
Mailing Address - Fax:
Practice Address - Street 1:5081 E HACIENDA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89122-6940
Practice Address - Country:US
Practice Address - Phone:725-249-3611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant