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NPI Code Detail

MEDICARE: JESSICA LAGOR MIDWIFE

MEDICARE:   JESSICA  LAGOR  MIDWIFE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175M00000XLay Midwife

General Provider Information

NPI Number : 1245705219
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA LAGOR MIDWIFE
Provider Business Mailing Address
First Line : 126 RUDIN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89124-9243
Country : US
Telephone Number : 702-271-6475
Fax Number : 702-829-5252
Provider Business Practice Location Address
First Line : 979 MONTE DE ORO AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89183-4669
Country : US
Telephone Number : 702-271-6475
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2018
Last Update Date : 10/05/2018

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Directions to “ JESSICA LAGOR MIDWIFE” Practice Location

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