Individual
JACLYN DE GROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4505 S MARYLAND PKWY, LAS VEGAS, NV 89154-9900
(702) 895-3370
Mailing address
4505 S MARYLAND PKWY # 453020, LAS VEGAS, NV 89154-9900
(702) 895-3370
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
22234
CA
363LF0000X
Family Nurse Practitioner
Primary
APRN001611
NV
Other
Enumeration date
02/28/2013
Last updated
07/06/2020
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