Healthcare Provider Details

I. General information

NPI: 1902728033
Provider Name (Legal Business Name): JOCELYN JOLEEN ESTES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7211 W CHARLESTON BLVD
LAS VEGAS NV
89117-1638
US

IV. Provider business mailing address

4730 ENGLISH LAVENDER AVE
NORTH LAS VEGAS NV
89031-3406
US

V. Phone/Fax

Practice location:
  • Phone: 702-388-8899
  • Fax: 702-388-2966
Mailing address:
  • Phone: 702-308-4499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number175T00000X
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: