Healthcare Provider Details

I. General information

NPI: 1235271263
Provider Name (Legal Business Name): NORA C BARRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1257 PAIUTE CIR
LAS VEGAS NV
89106-3202
US

IV. Provider business mailing address

8000 BADURA AVE APT 1129
LAS VEGAS NV
89113-2105
US

V. Phone/Fax

Practice location:
  • Phone: 702-382-0784
  • Fax:
Mailing address:
  • Phone: 702-672-5219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberPT06427
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: