Individual provider · Type 1 NPI
Davita Jackson-Clark, FNP
Family Nurse Practitioner · Las Vegas, NV
NPI number
1871018176
Active
Practice location
6600 W Charleston Blvd Ste 111
Las Vegas, NV 89146-1067
Fax (702) 763-7443
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | APRN002570 (NV) |
Family Nurse Practitioner: Definition to come...
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About NPI 1871018176
Davita Jackson-Clark, FNP's National Provider Identifier is 1871018176, issued on Aug 8, 2017. 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 Dec 23, 2023.