Provider Demographics
NPI:1033783972
Name:MONGKHOLTHAM-JONES, NALANI (FNP)
Entity Type:Individual
Prefix:
First Name:NALANI
Middle Name:
Last Name:MONGKHOLTHAM-JONES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 PRISTINE ESTATE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89086-1539
Mailing Address - Country:US
Mailing Address - Phone:702-466-9971
Mailing Address - Fax:
Practice Address - Street 1:211 W ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-7102
Practice Address - Country:US
Practice Address - Phone:702-823-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-15
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN71011163WE0003X
NV845477363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WE0003XNursing Service ProvidersRegistered NurseEmergency