MEDICARE: ALAN B JAUREGUI APRN

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
1	363LP2300X	Primary Care Nurse Practitioner	APRN000962	NV
2	363LF0000X	Family Nurse Practitioner	APRN000962	NV
3	363LP0200X	Pediatric Nurse Practitioner	APRN000962	NV

General Provider Information

NPI Number	:	1972792075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN B JAUREGUI APRN

Provider Business Mailing Address
First Line	:	5876 S PECOS RD
Second Line	:	BUILDING B
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3418
Country	:	US
Telephone Number	:	702-733-0744
Fax Number	:	702-796-8262

Provider Business Practice Location Address
First Line	:	5876 S PECOS RD
Second Line	:	BUILDING B
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3418
Country	:	US
Telephone Number	:	702-733-0744
Fax Number	:	702-796-8262

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/15/2007
Last Update Date	:	02/09/2017

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Directions to “ ALAN B JAUREGUI APRN” Practice Location

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