person
Mrs. Jessica E Radivan, PA-C
Medical Physician Assistant in Las Vegas, Nevada
NPI 1720228612

Jessica E Radivan is a Medical Physician Assistant based in Las Vegas, NV and is specialized in Medical. Jessica E Radivan practices in Las Vegas, NV and has the professional credentials of PA-C. The NPI Number for Jessica E Radivan is 1720228612 and holds a License No. PA1146 (Nevada).

The current practice location address for Jessica E Radivan is 888 S Rancho Dr, Las Vegas, NV and can be reached out via phone at 702-877-8600 and via fax at 702-258-6152.

Location: 888 S Rancho Dr, Las Vegas, NV, 89114-5645
person
Provider Profile Details
NPI Number
1720228612
Provider Name
Jessica E Radivan
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
888 S Rancho Dr, Las Vegas, NV, 89114-5645
Phone Number
702-877-8600
Fax Number
702-258-6152
Provider Enumeration Date
03/05/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
V110828 01 NV SMA MEDICARE
1720228612 05 NV
institution
Provider Business Practice Location Address Details
Address
888 S Rancho Dr
City
State
Zip
89106-3810
Phone Number
702-877-8600
Fax Number
702-258-6152
person
Provider Business Mailing Address Details
Address
888 S Rancho Dr
City
State
Zip
89106-3810
Phone Number
702-877-8600
Fax Number
702-258-6152
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA1146 (Nevada)
Definition
Definition to come...
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