Organization
JERO MULTISPECIALTY LLC
Active
Organization
JERO MULTISPECIALTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARICELJEAN RYCRAFT (ADMINISTRATOR)
(725) 232-8649
Entity
Organization
Contact information
Practice address
624 CHASE TREE ST, LAS VEGAS, NV 89144-4502
(702) 556-3671
Mailing address
624 CHASE TREE ST, LAS VEGAS, NV 89144-4502
(702) 556-3671
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/15/2024
Last updated
04/15/2024
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