Individual
JILLIAN EVE BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3930 HOWARD HUGHES PKWY STE 300, LAS VEGAS, NV 89169-0946
(702) 560-2192
Mailing address
7600 S JONES BLVD APT 2032, LAS VEGAS, NV 89139-0530
(209) 450-1893
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
879408
NV
Other
Enumeration date
08/14/2024
Last updated
08/14/2024
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