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NPI Code Detail

MEDICARE: NATHALIE M CLYNE

MEDICARE: NATHALIE M CLYNE
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1235149303
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHALIE M CLYNE
Provider Business Mailing Address
First Line : 4538 W CRAIG RD STE 290
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-2511
Country : US
Telephone Number : 702-486-5515
Fax Number :
Provider Business Practice Location Address
First Line : 4538 W CRAIG RD STE 290
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-2511
Country : US
Telephone Number : 702-486-5515
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2006
Last Update Date : 03/26/2015

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Directions to “ NATHALIE M CLYNE ” Practice Location

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