Healthcare Provider Details

I. General information

NPI: 1750076709
Provider Name (Legal Business Name): LABRINA URSULA PICHON CST/CSFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2023
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2741 HARTWICK PINES DR
HENDERSON NV
89052-7002
US

IV. Provider business mailing address

2741 HARTWICK PINES DR
HENDERSON NV
89052-7002
US

V. Phone/Fax

Practice location:
  • Phone: 410-231-0649
  • Fax:
Mailing address:
  • Phone: 410-231-0649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: