Provider Demographics
NPI:1679816755
Name:ILAGAN, JAY RAMOS (RN)
Entity Type:Individual
Prefix:MR
First Name:JAY
Middle Name:RAMOS
Last Name:ILAGAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:MR
Other - First Name:JULIUS
Other - Middle Name:RAMOS
Other - Last Name:ILAGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:2212 DAWN LILY COURT
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081
Mailing Address - Country:US
Mailing Address - Phone:702-374-5000
Mailing Address - Fax:
Practice Address - Street 1:2212 DAWN LILY COURT
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081
Practice Address - Country:US
Practice Address - Phone:702-374-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN34430163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse