Provider Demographics
NPI:1083857916
Name:LAGER, ANDREW JEROME (RN, BSN, MBA)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:JEROME
Last Name:LAGER
Suffix:
Gender:M
Credentials:RN, BSN, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1736 STAGECOACH DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-3412
Mailing Address - Country:US
Mailing Address - Phone:702-454-1996
Mailing Address - Fax:702-636-3041
Practice Address - Street 1:1736 STAGECOACH DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-3412
Practice Address - Country:US
Practice Address - Phone:702-454-1996
Practice Address - Fax:702-636-3041
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN 29216163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse