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NPI Code Detail

MEDICARE: CHARLENE SMITH

MEDICARE: CHARLENE SMITH
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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1225300981
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLENE SMITH
Provider Business Mailing Address
First Line : 7251 W LAKE MEAD BLVD
Second Line : SUITE 300
City : LAS VEGAS
State : NV
Zip : 89128-0274
Country : US
Telephone Number : 702-562-4096
Fax Number : 702-562-4092
Provider Business Practice Location Address
First Line : 6330 MCLEOD DR STE 3
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-4431
Country : US
Telephone Number : 702-487-5480
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2012
Last Update Date : 06/18/2019

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Directions to “ CHARLENE SMITH ” Practice Location

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