Individual
JACQUELINE PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9260 W SUNSET RD STE 110, LAS VEGAS, NV 89148-4903
(702) 916-6902
Mailing address
9260 W SUNSET RD STE 110, LAS VEGAS, NV 89148-4903
(702) 916-6902
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/18/2024
Last updated
05/13/2024
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