Individual provider · Type 1 NPI

Jessica E. Radivan, PA-C

Medical Physician Assistant · Las Vegas, NV

NPI number 1720228612 Active

Practice location

888 S Rancho Dr
Las Vegas, NV 89106-3810

Call (702) 877-8600 Map

Fax (702) 258-6152

Mailing address

PO Box 15645
Las Vegas, NV 89114-5645

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA1146 (NV)

Medical Physician Assistant: Definition to come...

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About NPI 1720228612

Jessica E. Radivan, PA-C's National Provider Identifier is 1720228612, issued on Mar 5, 2009. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Las Vegas, NV. The record was last updated on Jan 23, 2017.