Healthcare Provider Details

I. General information

NPI: 1508489568
Provider Name (Legal Business Name): RENEE LIU-MELK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2020
Last Update Date: 05/26/2020
Certification Date: 05/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1928 E CHARLESTON BLVD STE A
LAS VEGAS NV
89104-1993
US

IV. Provider business mailing address

1928 E CHARLESTON BLVD STE A
LAS VEGAS NV
89104-1993
US

V. Phone/Fax

Practice location:
  • Phone: 702-678-5089
  • Fax: 702-432-0031
Mailing address:
  • Phone: 702-678-5089
  • Fax: 702-432-0031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: