Individual provider · Type 1 NPI
Jaclyn De Groot, NP
Family Nurse Practitioner · Las Vegas, NV
NPI number
1306186259
Active
Practice location
4505 S Maryland Pkwy
Las Vegas, NV 89154-9900
Mailing address
4505 S Maryland Pkwy # 453020
Las Vegas, NV 89154-9900
Other practice locations
- 10000 Lakewood Blvd, Downey, CA 90240-4020 · (562) 862-3684
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 22234 (CA) |
| Family Nurse Practitioner Primary | 363LF0000X | APRN001611 (NV) |
Family Nurse Practitioner: Definition to come...
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About NPI 1306186259
Jaclyn De Groot, NP's National Provider Identifier is 1306186259, issued on Feb 28, 2013. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Las Vegas, NV. The record was last updated on Jul 6, 2020.