Provider Demographics
NPI:1942035076
Name:VINEY, ANTRENALE
Entity type:Individual
Prefix:
First Name:ANTRENALE
Middle Name:
Last Name:VINEY
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 1:7480 ADEMAR ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-2669
Mailing Address - Country:US
Mailing Address - Phone:209-565-7765
Mailing Address - Fax:
Practice Address - Street 1:7480 ADEMAR ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-2669
Practice Address - Country:US
Practice Address - Phone:209-565-7765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant