Provider Demographics
NPI:1649606161
Name:PARC, NATALIE VICTORIA (PHARMD)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:VICTORIA
Last Name:PARC
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 W WIGWAM AVE
Mailing Address - Street 2:APT. 1209
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-6643
Mailing Address - Country:US
Mailing Address - Phone:702-463-2641
Mailing Address - Fax:
Practice Address - Street 1:1701 N GREEN VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-5885
Practice Address - Country:US
Practice Address - Phone:702-897-5884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV18375183500000X
UT8370054-1701183500000X
UT8370054-8911183500000X
OH03131889-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist