NPI 1417831140

Richard Yvanovich

Practitioner Driver Las Vegas, NV

Practice location

Address: 9083 Jade Vine Ave, Las Vegas, NV 89148-2620
Phone: (702) 793-1195

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence 1606111384 (NV)

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Registry record

NPI: 1417831140
Entity type: Individual
Sex (as registered): Male
NPI issued: 5 Aug 2025
Record last updated: 5 Aug 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.