Provider Demographics
NPI:1548868284
Name:ANDERSON, KAMIA
Entity type:Individual
Prefix:
First Name:KAMIA
Middle Name:
Last Name:ANDERSON
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 1:8480 S EASTERN AVE STE F
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2822
Mailing Address - Country:US
Mailing Address - Phone:702-830-5325
Mailing Address - Fax:702-830-4385
Practice Address - Street 1:8480 S EASTERN AVE STE F
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2822
Practice Address - Country:US
Practice Address - Phone:702-830-5325
Practice Address - Fax:702-830-4385
Is Sole Proprietor?:No
Enumeration Date:2020-10-14
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV374J00000X
3747A0650X, 374U00000X, 376J00000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Yes374J00000XNursing Service Related ProvidersDoula
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker