Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0120X | Pediatric Surgery | A11813 | CA |
Y | 2086S0120X | Pediatric Surgery | DO2170 | NV |
NPI | 1184777120 |
---|---|
Provider Name | Dr. Stephanie Jones |
First Address | Las Vegas, NV 89102-1963 |
Second Address | Las Vegas, NV 89109-2309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 08/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1184777120 | (05) | NV |