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NPI Code Detail

MEDICARE: MR. JESSE THI MAI FNP-C

MEDICARE: MR. JESSE THI MAI 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
1363L00000XNurse PractitionerAPN001468NV

General Provider Information

NPI Number : 1285970855
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JESSE THI MAI FNP-C
Provider Business Mailing Address
First Line : 4324 S EASTERN AVE STE B
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-6064
Country : US
Telephone Number : 702-405-8500
Fax Number : 702-405-8501
Provider Business Practice Location Address
First Line : 3227 E WARM SPRINGS RD STE 300
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-3180
Country : US
Telephone Number : 702-222-0034
Fax Number : 702-222-0659
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2012
Last Update Date : 03/17/2018

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Directions to “ MR. JESSE THI MAI FNP-C” Practice Location

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