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NPI Code Detail

MEDICARE: MILDRED LAVONNE LARRY

MEDICARE: MILDRED LAVONNE LARRY
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
13747A0650XAttendant Care ProviderNV

General Provider Information

NPI Number : 1972451623
Entity Type Code : Individual
Provider Name (Legal Business Name) : MILDRED LAVONNE LARRY
Provider Business Mailing Address
First Line : 2609 VANA AVE
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-8421
Country : US
Telephone Number : 702-262-1202
Fax Number : 702-749-6232
Provider Business Practice Location Address
First Line : 1820 E SAHARA AVE STE 114
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-3736
Country : US
Telephone Number : 702-262-1202
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2026
Last Update Date : 03/18/2026

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Directions to “ MILDRED LAVONNE LARRY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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