Healthcare Provider Details

I. General information

NPI: 1992634950
Provider Name (Legal Business Name): VALERIYA LERA KERUNETZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VALERIA GUBENCO

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 LOUIE B NUNN DR
NEWPORT KY
41099-9993
US

IV. Provider business mailing address

6806 DENTON CT
LAS VEGAS NV
89149-1460
US

V. Phone/Fax

Practice location:
  • Phone: 859-578-5660
  • Fax:
Mailing address:
  • Phone: 562-445-5868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number861825
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95359620
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number861825
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: