Individual
JOHNNY JESSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5550 PAINTED MIRAGE RD STE 320, LAS VEGAS, NV 89149-4584
(702) 818-1787
Mailing address
5550 PAINTED MIRAGE RD STE 320, LAS VEGAS, NV 89149-4584
(702) 818-1787
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
372600000X
Adult Companion
Primary
—
—
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
NV
Enumeration date
10/30/2020
Last updated
10/30/2020
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