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NPI Code Detail

MEDICARE: CHERYL A KAPALKA RD

MEDICARE: CHERYL A KAPALKA RD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1003878059
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHERYL A KAPALKA RD
Provider Business Mailing Address
First Line : 620 SHADOW LN
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-4119
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5400 S RAINBOW BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-1859
Country : US
Telephone Number : 702-853-3087
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2006
Last Update Date : 07/08/2007

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Directions to “ CHERYL A KAPALKA RD” Practice Location

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