Provider Demographics
NPI:1255918553
Name:TONEL, JEFFERSON MARK PEREZ (APRN-CNP)
Entity type:Individual
Prefix:
First Name:JEFFERSON MARK
Middle Name:PEREZ
Last Name:TONEL
Suffix:
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 MARKS STREET
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014
Mailing Address - Country:US
Mailing Address - Phone:702-671-1000
Mailing Address - Fax:702-458-0610
Practice Address - Street 1:525 MARKS STREET
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014
Practice Address - Country:US
Practice Address - Phone:702-671-1000
Practice Address - Fax:702-458-0610
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-24
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV839052363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty