Individual
CANDACE JORGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1161 S VALLEY VIEW BLVD, LAS VEGAS, NV 89102-1854
(702) 486-7670
Mailing address
1161 S VALLEY VIEW BLVD, LAS VEGAS, NV 89102-1854
(702) 486-7670
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
922445
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
922445
—
NV
Enumeration date
03/13/2020
Last updated
03/13/2020
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