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NPI Code Detail

MEDICARE: MRS. GLORY JANE ADER YORKE PA-C

MEDICARE: MRS. GLORY JANE ADER YORKE PA-C
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
1363A00000XPhysician AssistantPA21058CA
2363AM0700XMedical Physician AssistantPA1286NV
3363AM0700XMedical Physician AssistantPA0246NV

General Provider Information

NPI Number : 1447569363
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. GLORY JANE ADER YORKE PA-C
Provider Business Mailing Address
First Line : 10616 TRANQUIL GLADE LN
Second Line :
City : LAS VEGAS
State : NV
Zip : 89135-1216
Country : US
Telephone Number : 808-753-1838
Fax Number :
Provider Business Practice Location Address
First Line : 4100 W FLAMINGO RD STE 2100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-3926
Country : US
Telephone Number : 702-822-5000
Fax Number : 702-822-5001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2010
Last Update Date : 10/10/2012

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Directions to “ MRS. GLORY JANE ADER YORKE PA-C” Practice Location

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