MEDICARE: SHELLY BAILEY-SCHARNHORST BS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1003349952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELLY BAILEY-SCHARNHORST BS

Provider Business Mailing Address
First Line	:	6212 LANNING LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-2604
Country	:	US
Telephone Number	:	702-337-6614
Fax Number	:

Provider Business Practice Location Address
First Line	:	6887 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1600
Country	:	US
Telephone Number	:	702-778-9875
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2017
Last Update Date	:	10/28/2018

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