Provider Demographics
NPI:1033781943
Name:ANDERSON, JASMIN TIARA (DNP, BSN)
Entity Type:Individual
Prefix:DR
First Name:JASMIN
Middle Name:TIARA
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:DNP, BSN
Other - Prefix:DR
Other - First Name:JAS
Other - Middle Name:TIARA
Other - Last Name:MCGEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP, BSN
Mailing Address - Street 1:3312 W CHARLESTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1829
Mailing Address - Country:US
Mailing Address - Phone:702-291-7121
Mailing Address - Fax:
Practice Address - Street 1:3312 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1829
Practice Address - Country:US
Practice Address - Phone:702-410-7825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV843032363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily