Individual
CHERELLE PORCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12020 SOUTHERN HIGHLANDS PKWY APT 1136, LAS VEGAS, NV 89141-3006
(702) 824-6895
Mailing address
12020 SOUTHERN HIGHLANDS PKWY APT 1136, LAS VEGAS, NV 89141-3006
(702) 824-6895
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82-4982189
MEDICARE
NV
05
—
82-4982189
—
NV
Enumeration date
04/09/2019
Last updated
04/09/2019
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