Provider Demographics
NPI:1013205830
Name:PARKE, JAIME (CRNA)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:PARKE
Suffix:
Gender:F
Credentials:CRNA
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:129 W LAKE MEAD PKWY
Mailing Address - Street 2:SUITE B18
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-6954
Mailing Address - Country:US
Mailing Address - Phone:702-564-4440
Mailing Address - Fax:702-558-1522
Practice Address - Street 1:129 W LAKE MEAD PKWY
Practice Address - Street 2:SUITE B18
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-6954
Practice Address - Country:US
Practice Address - Phone:702-564-4440
Practice Address - Fax:702-558-1522
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVTRN331363367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered