Provenance Healthcare LLC
Provenance Healthcare LLC is a Genetic Counselor (M.S.) in Las Vegas, Nevada. Licensed in Nevada. Registered with an NPI since 2015.
- Licensed in
- NV
- In the registry since
- 2015
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
5155 S Durango Dr Ste 103Las Vegas, NV 89113-0175
Phone: (702) 478-2524
Fax: (702) 735-9074
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Genetic Counselor (M.S.) (primary) | Taxonomy 170300000X · Licence OTHER (NV) |
|---|
Record details
| NPI number | 1316322738 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Mark Black — Owner Operator · (702) 478-2524 |
| NPI enumerated | July 27, 2015 |
| Last updated in NPPES | July 27, 2015 |
| Mailing address | 5155 S Durango Dr Ste 103, Las Vegas, NV 89113-0175 |
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