Provider Demographics
NPI:1316660731
Name:HUMMINGBIRD CREDENTIALING LLC
Entity type:Organization
Organization Name:HUMMINGBIRD CREDENTIALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHAWNA
Authorized Official - Middle Name:
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-817-6672
Mailing Address - Street 1:850 S BOULDER HWY # 410
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-7564
Mailing Address - Country:US
Mailing Address - Phone:702-817-6672
Mailing Address - Fax:
Practice Address - Street 1:2204 CONCHITA ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108
Practice Address - Country:US
Practice Address - Phone:702-817-6672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744R1103XOther Service ProvidersSpecialistResearch Data Abstracter/CoderGroup - Multi-Specialty