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General NPI Number Information
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NPI Number | 1962357210
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Entity Type | Individual
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Provider Name | SIMONE BROOKER-JOLIVETTE
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Gender | Female
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Dates
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Enumeration Date | 03/02/2026
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 7373 PEAK DR
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City | LAS VEGAS
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State | NV
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Zip | 89128-9003
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Country | US
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Telephone | 725-780-4351
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Fax |
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Provider Business Mailing Address
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Address Line | 9929 MARKHORN CT
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City | LAS VEGAS
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State | NV
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Zip | 89149-3741
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 805542
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 840451
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License Number State | NV
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