Provider Demographics
NPI:1982400883
Name:LANDEROS, JOCELYNE
Entity type:Individual
Prefix:
First Name:JOCELYNE
Middle Name:
Last Name:LANDEROS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10092 HERMIT RAPIDS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-1635
Mailing Address - Country:US
Mailing Address - Phone:702-280-1971
Mailing Address - Fax:
Practice Address - Street 1:3087 E WARM SPRINGS RD STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3754
Practice Address - Country:US
Practice Address - Phone:702-463-1260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV840487163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health