Individual
RYAN E JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1200 S 4TH ST STE 111, LAS VEGAS, NV 89104-1046
(702) 380-8118
(702) 380-2929
Mailing address
1200 S 4TH ST STE 111, LAS VEGAS, NV 89104-1046
(702) 354-2400
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
849303
NV
163WC1500X
Community Health Registered Nurse
849303
NV
163WI0500X
Infusion Therapy Registered Nurse
849303
NV
Other
Enumeration date
05/17/2022
Last updated
12/19/2023
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