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NPI Code Detail

MEDICARE: PAULA URETT MCCONICO

MEDICARE:   PAULA URETT MCCONICO
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1932406113
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAULA URETT MCCONICO
Provider Business Mailing Address
First Line : 208 GEMSTONE HILL AVE
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-6861
Country : US
Telephone Number : 702-636-4186
Fax Number :
Provider Business Practice Location Address
First Line : 208 GEMSTONE HILL AVE
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-6861
Country : US
Telephone Number : 702-636-4186
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2011
Last Update Date : 02/23/2011

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Directions to “ PAULA URETT MCCONICO ” Practice Location

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