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General NPI Number Information
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NPI Number | 1699588475
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Entity Type | Individual
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Provider Name | JACLYN PRELL PMHNP
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Gender | Female
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 10655 PARK RUN DR STE 210
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City | LAS VEGAS
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State | NV
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Zip | 89144-4590
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Country | US
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Telephone | 702-375-3668
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Fax |
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Provider Business Mailing Address
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Address Line | 2009 MARBLE GORGE DR
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City | LAS VEGAS
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State | NV
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Zip | 89117-5955
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Country | US
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Telephone | 702-375-3668
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 886841
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License Number State | NV
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