Healthcare Provider Details

I. General information

NPI: 1245095314
Provider Name (Legal Business Name): JENNIFER LYNN VROMAN APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2024
Last Update Date: 02/19/2024
Certification Date: 02/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2785 E DESERT INN RD STE 230
LAS VEGAS NV
89121-3624
US

IV. Provider business mailing address

166 ROCKY STAR ST
HENDERSON NV
89012-5561
US

V. Phone/Fax

Practice location:
  • Phone: 702-981-0364
  • Fax:
Mailing address:
  • Phone: 702-439-4359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number874176
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: