Provider Demographics
NPI:1538592381
Name:SLAVICK, KERA RABACAL (PA-C)
Entity type:Individual
Prefix:
First Name:KERA
Middle Name:RABACAL
Last Name:SLAVICK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9030 W SAHARA AVE
Mailing Address - Street 2:SUITE 249
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-5744
Mailing Address - Country:US
Mailing Address - Phone:702-629-6992
Mailing Address - Fax:702-629-6994
Practice Address - Street 1:7251 W LAKE MEAD BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-8380
Practice Address - Country:US
Practice Address - Phone:702-629-6992
Practice Address - Fax:702-629-6992
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-15
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA1447363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical