MEDICARE: MS. CHARVELLE DIONNE HARRISON

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	:	1790137750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHARVELLE DIONNE HARRISON

Provider Business Mailing Address
First Line	:	7300 PIRATES COVE RD
Second Line	:	2042
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-4290
Country	:	US
Telephone Number	:	702-488-4058
Fax Number	:

Provider Business Practice Location Address
First Line	:	7300 PIRATES COVE RD
Second Line	:	2042
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-4290
Country	:	US
Telephone Number	:	702-488-4058
Fax Number	:

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

Provider Enumeration Date	:	07/01/2016
Last Update Date	:	07/01/2016

Similar Medicare Providers

1528285046 — DR. STEVEN WEIN D.O.
Practice Location Address:

7300 PIRATES COVE RD , UNIT#2045
LAS VEGAS, NV
89145-4290

Practice Phone: 305-761-6788
Practice Fax:

1649550674 — MR. JUQUA KINTE GLOVER
Practice Location Address:

7300 PIRATES COVE RD , 2011
LAS VEGAS, NV
89145-4290

Practice Phone: 702-300-8004
Practice Fax:

1396212213 — JENNIFER LYNN AZCARRAGA
Practice Location Address:

4290 EL ANTONIO PL
LAS VEGAS, NV
89121-6618

Practice Phone: 702-467-8017
Practice Fax:

1134719933 — STACEY DARCEL MADDEN
Practice Location Address:

4290 EAGLE ISLAND ST
LAS VEGAS, NV
89130-1424

Practice Phone: 702-824-3098
Practice Fax:

1306504469 — NANCY BASCO
Practice Location Address:

4290 CHAFER DR
LAS VEGAS, NV
89121-4653

Practice Phone: 702-378-8514
Practice Fax:

1114469012 — JORGE GARCIA ORTIZ
Practice Location Address:

BLVD. LAS AMERICAS 4290 1 , FRACC. LOMAS DE AGUA CALIENTE
TIJUANA, BAJA CALIFORNIA
22024

Practice Phone: 664-681-9136
Practice Fax: 866-272-6924

Directions to “ MS. CHARVELLE DIONNE HARRISON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.