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General NPI Number Information
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NPI Number | 1962280784
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Entity Type | Individual
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Provider Name | PRECIOUS MCCORVEY
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Gender | Female
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Dates
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Enumeration Date | 09/21/2023
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Last Update Date | 09/21/2023
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Provider Practice Location Address
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Address Line | 4892 E VASSAR AVE
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City | FRESNO
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State | CA
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Zip | 93703-2878
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Country | US
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Telephone | 559-403-9721
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 792750
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City | SAN ANTONIO
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State | TX
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Zip | 78279-2750
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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