Individual ProviderLailani BautistaTechnicianNursing Service Related ProvidersPractice Address2770 S Maryland Pkwy Ste Aand213b, Las Vegas, NV 89109-1554(702) 331-0100(702) 788-1449PECOS EnrollmentBased on the most recent information from CMS, provider Lailani Bautista does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1033865332Provider TypeIndividualFull NameBautista, LailaniGenderFemaleSole ProprietorNoEnumeration Date2/24/2022Last Updated2/24/2022Contact InformationPractice LocationPractice Address2770 S Maryland Pkwy Ste Aand213b, Las Vegas, NV 89109-1554Phone(702) 331-0100FaxUnlisted FaxMailing LocationMailing Address2312 Canosa Ave, Las Vegas, NV 89104-4203Phone(702) 788-1449FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode3747P1801XPrimaryDescriptionTechnicianNursing Service Related ProvidersLicenseUnlisted Issuer