Individual
JESRON MARPAUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6540 BLACK OAKS ST, NORTH LAS VEGAS, NV 89084-2045
(909) 913-8647
Mailing address
6540 BLACK OAKS ST, NORTH LAS VEGAS, NV 89084-2045
(909) 913-8647
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F10201409
NV
Other
Enumeration date
03/09/2021
Last updated
03/09/2021
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