Provider Demographics
NPI:1467284125
Name:ARANDA, JACQUELINE GRACE (APRN)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:GRACE
Last Name:ARANDA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 PERFECT BERM LN
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-3318
Mailing Address - Country:US
Mailing Address - Phone:619-389-8658
Mailing Address - Fax:
Practice Address - Street 1:1015 PERFECT BERM LN
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89002-3318
Practice Address - Country:US
Practice Address - Phone:619-389-8658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11032880363LP0808X
NV878941363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health