Healthcare Provider Details

I. General information

NPI: 1275417503
Provider Name (Legal Business Name): MISS VARAPORN UKERD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS MAE UKERD

II. Dates (important events)

Enumeration Date: 07/31/2025
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4613 W DESERT INN RD
LAS VEGAS NV
89102-7116
US

IV. Provider business mailing address

3489 SUNNY DUNES CT
LAS VEGAS NV
89121-5080
US

V. Phone/Fax

Practice location:
  • Phone: 702-758-9539
  • Fax:
Mailing address:
  • Phone: 773-969-1415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNV
# 4
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: