Individual
JACLYN T O'CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
4490 N RANCHO DR, LAS VEGAS, NV 89130-3406
(702) 655-0550
(702) 655-0545
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
363LF0000X
Family Nurse Practitioner
Primary
811853
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912761438
—
NV
01
—
811853
STATE LICENSE
NV
Enumeration date
02/06/2024
Last updated
07/08/2024
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