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General NPI Number Information
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NPI Number | 1326474685
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Entity Type | Individual
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Provider Name | JON FAILLA APRN
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Gender | Male
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Dates
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Enumeration Date | 09/18/2013
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Last Update Date | 11/02/2022
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Provider Practice Location Address
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Address Line | 4270 S DECATUR BLVD STE B6
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City | LAS VEGAS
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State | NV
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Zip | 89103-6802
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Country | US
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Telephone | 702-485-2100
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Fax | 702-825-0091
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Provider Business Mailing Address
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Address Line | 182 APACHE TEAR CT
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City | LAS VEGAS
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State | NV
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Zip | 89123-2996
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Country | US
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Telephone | 702-546-6864
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Fax | 775-251-9896
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | RN61345
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | APRN002252
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN002252
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License Number State | NV
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