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General NPI Number Information
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NPI Number | 1174268429
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Entity Type | Organization
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Legal Business Name | JGBB LLC
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Dates
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Enumeration Date | 05/02/2022
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 7151 CASCADE VALLEY CT UNIT 101102 UNIT 101 AND 102
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City | LAS VEGAS
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State | NV
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Zip | 89128-0496
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Country | US
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Telephone | 702-825-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 801 S RANCHO DR STE D1-B
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City | LAS VEGAS
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State | NV
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Zip | 89106-3854
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Country | US
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Telephone | 702-587-5833
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Fax |
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Authorized Official
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Title or Position | REGIONAL MANAGER
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Name | TERESA PATAWARAN BUCO
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Credential | RN
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Telephone | 702-478-5133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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