Provider Demographics
NPI:1083595326
Name:QUARLES, WILLIAM RAYMOND III (PRSSS, CHW1, PCA)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:RAYMOND
Last Name:QUARLES
Suffix:III
Gender:M
Credentials:PRSSS, CHW1, PCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 ATRIUM RD
Mailing Address - Street 2:
Mailing Address - City:FERNLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89408-7597
Mailing Address - Country:US
Mailing Address - Phone:775-842-8586
Mailing Address - Fax:
Practice Address - Street 1:920 ATRIUM RD
Practice Address - Street 2:
Practice Address - City:FERNLEY
Practice Address - State:NV
Practice Address - Zip Code:89408-7597
Practice Address - Country:US
Practice Address - Phone:775-842-8586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV20244479P251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1871473140Medicaid