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Individual
JACLYN NICOLE RYAVE
Active
Individual
JACLYN NICOLE RYAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO2920
NV
207Q00000X
Family Medicine Physician
SL1362
NV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518462746
—
NV
01
—
DO2920
STATE LICENSE
NV
01
—
SL1362
MEDICAL LICENSE
NV
Enumeration date
03/28/2018
Last updated
03/07/2023
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