Individual
JENIFFER CREQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
6040 S FORT APACHE RD STE 100, LAS VEGAS, NV 89148-5613
(702) 476-4900
(702) 476-4949
Mailing address
6040 S FORT APACHE RD STE 100, LAS VEGAS, NV 89148-5613
(702) 476-4900
(702) 476-4949
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
815834
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018070364
ANCC
MD
01
—
815834
APRN LICENSE
NV
Enumeration date
12/14/2018
Last updated
12/14/2018
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