Healthcare Provider Details

I. General information

NPI: 1164901161
Provider Name (Legal Business Name): JESUS ALEXIE ROMERO ARNP, PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2018
Last Update Date: 06/23/2022
Certification Date: 06/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 PASEO VERDE PKWY STE 190
HENDERSON NV
89052-2703
US

IV. Provider business mailing address

4531 N 16TH ST STE 114
PHOENIX AZ
85016-5344
US

V. Phone/Fax

Practice location:
  • Phone: 702-589-4871
  • Fax: 702-589-4872
Mailing address:
  • Phone: 602-266-8700
  • Fax: 602-296-0404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP11647
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number821846
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: