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PROVENANCE HEALTHCARE LLC NPI 1316322738


NPI Information

NPI: 1316322738
Provider Name: PROVENANCE HEALTHCARE LLC
Classification: Genetic Counselor, MS - 170300000X
Entity Type: Organization
Address:
5155 S DURANGO DR STE 103
LAS VEGAS, NV
ZIP 89113
Phone: (702) 478-2524
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PROVENANCE HEALTHCARE LLC is a genetic counselor ms in Las Vegas, NV. The provider is a masters trained health care provider who collects and interprets genetic family histories; assesses the risk of disease occurrence or recurrence; identifies interventions to manage or ameliorate disease risk; educates about inheritance, testing, management, prevention, ethical issues, resources, and research; and counsels to promote informed choices and adaptation. Certification was established in 1993 by the American Board of Genetic Counseling and prior to that by the American Board of Medical Genetics. Requirements for experience, licensure, and job responsibilities vary among the states. PROVENANCE HEALTHCARE LLC NPI is 1316322738. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5155 S DURANGO DR STE 103
LAS VEGAS, NV
ZIP 89113-175
Phone: (702) 478-2524
Fax: (702) 735-9074

The provider's authorized official is Mark L Black .
The authorized official title is Owner Operator and has the following contact phone number (702) 478-2524.

The enumeration date for this NPI number is 7/27/2015 and was last updated on 7/27/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1170300000XGenetic Counselor, MSOTHERNEVADAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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