Healthcare Provider Details

I. General information

NPI: 1285861419
Provider Name (Legal Business Name): JEFFREY ALAN HULME RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2009
Last Update Date: 12/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 PECOS RD
NORTH LAS VEGAS NV
89086-4400
US

IV. Provider business mailing address

6900 N PECOS RD
NORTH LAS VEGAS NV
89086
US

V. Phone/Fax

Practice location:
  • Phone: 954-805-3771
  • Fax:
Mailing address:
  • Phone: 954-805-3771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License NumberRT 4118
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: