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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205462991 NPPES
Nevada MEDICAID 922445

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