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NPI Code Detail

MEDICARE: DR. JACKLINE B NGALAME PMHNP

MEDICARE: DR. JACKLINE B NGALAME PMHNP
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner53-78727-072KS
2363LP0808XPsychiatric/Mental Health Nurse Practitioner402559NY
3363LP0808XPsychiatric/Mental Health Nurse PractitionerAP60741863WA
4363LP0808XPsychiatric/Mental Health Nurse Practitioner839166NV
5363LF0000XFamily Nurse Practitioner343912NY
6363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN11018101FL
7363LP0808XPsychiatric/Mental Health Nurse Practitioner9142MN

General Provider Information

NPI Number : 1861869703
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACKLINE B NGALAME PMHNP
Provider Business Mailing Address
First Line : 10409 PACIFIC PALISADES AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89144-1221
Country : US
Telephone Number : 702-281-8941
Fax Number : 440-597-4344
Provider Business Practice Location Address
First Line : 10409 PACIFIC PALISADES AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89144-1221
Country : US
Telephone Number : 702-281-8941
Fax Number : 440-597-4344
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2015
Last Update Date : 10/13/2025

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