Individual
JAE-CAMILLE ROSALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5771 S FORT APACHE RD, LAS VEGAS, NV 89148-5660
(702) 951-3400
Mailing address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 216-3346
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2407
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780273920
—
NV
01
—
PA2407
STATE LICENSE
NV
Enumeration date
01/12/2021
Last updated
01/08/2024
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