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NPI Code Detail

MEDICARE: JAIME LEE DELIVUK FNP-C

MEDICARE: JAIME LEE DELIVUK FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner879671NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2879671OTHERNVLICENSE

General Provider Information

NPI Number : 1043942741
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAIME LEE DELIVUK FNP-C
Provider Business Mailing Address
First Line : 6355 S BUFFALO DR FL 3
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-2133
Country : US
Telephone Number : 702-216-3346
Fax Number :
Provider Business Practice Location Address
First Line : 2350 CORPORATE CIR STE 100
Second Line :
City : HENDERSON
State : NV
Zip : 89074-7738
Country : US
Telephone Number : 702-968-7210
Fax Number : 702-735-7153
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2022
Last Update Date : 02/09/2026

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