Healthcare Provider Details

I. General information

NPI: 1710450614
Provider Name (Legal Business Name): ERIN VERONICK CST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2019
Last Update Date: 01/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10561 JEFFREYS ST STE 230
HENDERSON NV
89052-4268
US

IV. Provider business mailing address

10561 JEFFREYS ST STE 230
HENDERSON NV
89052-4268
US

V. Phone/Fax

Practice location:
  • Phone: 702-565-6565
  • Fax: 702-565-8898
Mailing address:
  • Phone: 702-565-6565
  • Fax: 702-565-8898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZX2200X
TaxonomyOrthopedic Assistant
License Number180738
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: