Healthcare Provider Details

I. General information

NPI: 1235338146
Provider Name (Legal Business Name): CLARENCE DANIEL CUMMINS CRT, RCP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 11/23/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 N GREEN VALLEY PKWY STE 8B
HENDERSON NV
89074-5990
US

IV. Provider business mailing address

1701 N GREEN VALLEY PKWY STE 8B
HENDERSON NV
89074-5990
US

V. Phone/Fax

Practice location:
  • Phone: 702-914-2790
  • Fax: 702-914-5984
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2278P1005X
TaxonomyPulmonary Rehabilitation Certified Respiratory Therapist
License NumberRC360
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: