Jorgensen, Candace
Jorgensen, Candace is an individual health care provider with primary practice located at 1161 S Valley View Blvd , Las Vegas NV 89102-1854. She recently has only one registered license in Dietary & Nutritional Service Providers / Nutrition, Pediatric, which is considered as her primary health care specialty. Jorgensen, Candace can be contacted via phone (702) 486-7670.Contact Information
Primary practice address
1161 S Valley View Blvd
Las Vegas NV 89102-1854
Phone: (702) 486-7670
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dietary & Nutritional Service Providers / Nutrition, Pediatric | 133VN1004X | 922445 | Nevada |
Profile Details
NPI number | 1205462991 |
---|---|
LBN Legal business name | Jorgensen, Candace |
Credentials | |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 13th, 2020 |
Last updated | Mar 13th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1205462991 | NPPES |
Nevada | MEDICAID | 922445 |
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