Individual
DAVITA JACKSON-CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
6600 W CHARLESTON BLVD STE 111, LAS VEGAS, NV 89146-1067
(702) 763-7443
(702) 763-7443
Mailing address
6600 W CHARLESTON BLVD STE 111, LAS VEGAS, NV 89146-1067
(702) 763-7443
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN002570
NV
Other
Enumeration date
08/08/2017
Last updated
12/23/2023
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