Healthcare Provider Details

I. General information

NPI: 1083540199
Provider Name (Legal Business Name): NADIJA JAEGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3035 S JONES BLVD
LAS VEGAS NV
89146-6781
US

IV. Provider business mailing address

5029 TROPICAL CLIFF AVE
LAS VEGAS NV
89130-7224
US

V. Phone/Fax

Practice location:
  • Phone: 702-829-1021
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT6619
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: