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General NPI Number Information
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NPI Number | 1922613926
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Entity Type | Individual
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Provider Name | JHANH RACKLEY
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Gender | Female
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Dates
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Enumeration Date | 09/15/2020
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Last Update Date | 09/15/2020
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Provider Practice Location Address
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Address Line | 4001 S DECATUR BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89103-5860
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Country | US
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Telephone | 702-248-6510
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Fax |
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Provider Business Mailing Address
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Address Line | 10021 CRIMSON PALISADES PL UNIT 101
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City | LAS VEGAS
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State | NV
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Zip | 89144-7031
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Country | US
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Telephone |
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 20673
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License Number State | NV
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