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NPI Code Detail

MEDICARE: VALERIA CLARK

MEDICARE:   VALERIA  CLARK
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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1366101206
Entity Type Code : Individual
Provider Name (Legal Business Name) : VALERIA CLARK
Provider Business Mailing Address
First Line : 410 S RAMPART BLVD STE 390
Second Line :
City : LAS VEGAS
State : NV
Zip : 89145-5749
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4652 N RAINBOW BLVD APT 223
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-5745
Country : US
Telephone Number : 702-337-2584
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2021
Last Update Date : 12/08/2021

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Directions to “ VALERIA CLARK ” Practice Location

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