Individual
JAKE GIFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3001 SAINT ROSE PKWY, HENDERSON, NV 89052-3839
(702) 616-5615
(702) 616-5120
Mailing address
PO BOX 33269, PHOENIX, AZ 85067-3269
(602) 406-4786
(916) 636-4358
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA3131
NV
Other
Enumeration date
06/06/2021
Last updated
06/02/2025
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