Provider Demographics
NPI:1083291397
Name:JAMISON, ARLYNE EVASCO (APRN-CNP)
Entity type:Individual
Prefix:
First Name:ARLYNE
Middle Name:EVASCO
Last Name:JAMISON
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 N NELLIS BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110
Mailing Address - Country:US
Mailing Address - Phone:702-383-6250
Mailing Address - Fax:702-459-8586
Practice Address - Street 1:63 N NELLIS BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110
Practice Address - Country:US
Practice Address - Phone:702-383-6250
Practice Address - Fax:702-459-8586
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-24
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV839069363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily