Healthcare Provider Details

I. General information

NPI: 1538696943
Provider Name (Legal Business Name): JENNIFER LYNN DAO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2017
Last Update Date: 05/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2011 PINTO LN STE 200
LAS VEGAS NV
89106-4007
US

IV. Provider business mailing address

8824 BORLA DR
LAS VEGAS NV
89117-1101
US

V. Phone/Fax

Practice location:
  • Phone: 702-382-3200
  • Fax:
Mailing address:
  • Phone: 702-525-6316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN002499
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: