Provider Demographics
NPI:1447912217
Name:ROYCE, CARMEN
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:ROYCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 W LAKE MEAD BLVD # 9344
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0297
Mailing Address - Country:US
Mailing Address - Phone:913-980-2476
Mailing Address - Fax:
Practice Address - Street 1:3053 W CRAIG RD STE E228
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-5124
Practice Address - Country:US
Practice Address - Phone:913-980-2476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator