Provider Demographics
NPI:1972829794
Name:VIELEHR, CAROL P (PA)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:P
Last Name:VIELEHR
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10001 S EASTERN AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3908
Mailing Address - Country:US
Mailing Address - Phone:702-566-2400
Mailing Address - Fax:702-433-2477
Practice Address - Street 1:10001 S EASTERN AVE STE 310
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052
Practice Address - Country:US
Practice Address - Phone:702-566-2400
Practice Address - Fax:702-433-2477
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA1314363A00000X
NY013268363A00000X
NVPA1538208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1972829794Medicaid