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DAVITA JACKSON-CLARK FNP
NPI 1871018176
Nurse Practitioner - Family in Las Vegas, NV

Active since August 08, 2017
6600 W CHARLESTON BLVD STE 111, LAS VEGAS, NV 89146(702) 763-7443(702) 763-7443 Get Directions Write a Review

NPPES record last updated: December 23, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 28, 2020, May 13, 2019, Jun 16, 2018 and 1 more (4 updates tracked since 2017).

About Davita Jackson-clark Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DAVITA JACKSON-CLARK FNP (NPI 1871018176) is an individual family provider in Las Vegas, Nevada, licensed in Nevada (APRN002570) and active in the NPI registry since August 2017.

NPPES Registry Identity

NPI1871018176
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameDAVITA JACKSON-CLARKCredential: FNP
Location Address6600 W CHARLESTON BLVD STE 111Las Vegas, NV 89146-1067
Mailing Address6600 W Charleston Blvd Ste 111Las Vegas, NV 89146-1067 · (702) 763-7443
Phone(702) 763-7443
Fax(702) 763-7443
Sole ProprietorNo
Enumeration DateAugust 8, 2017
Last NPPES UpdateDecember 23, 20234 updates tracked since enumeration
NPPES CertifiedDecember 23, 2023
✔ NPI 1871018176 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NV · APRN002570
6600 W CHARLESTON BLVD STE 111, Las Vegas, NV 89146
Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

YULINHO ROMERO
Behavior Technician
6600 W CHARLESTON BLVD STE 111
LAS VEGAS, NV 89146
Clark County (702) 283-6215
MR. KRAYTON STEPHENS LCSW
Social Worker (Clinical)
6600 W CHARLESTON BLVD STE 111
LAS VEGAS, NV 89146
Clark County (702) 763-7443
ASRIANA MALIWAT CASE MANAGER
Case Manager/Care Coordinator
6600 W CHARLESTON BLVD STE 111
LAS VEGAS, NV 89146
Clark County (702) 763-7443
ARIANA RENE SMITH
Behavior Technician
6600 W CHARLESTON BLVD STE 111
LAS VEGAS, NV 89146
Clark County (702) 283-6215
ANTHONY STUART RIVERA
Social Worker (Clinical)
6600 W CHARLESTON BLVD STE 111
LAS VEGAS, NV 89146
Clark County (702) 763-7443
NEW APPROACH
Counselor (Addiction (Substance Use Disorder))
6600 W CHARLESTON BLVD STE 111
LAS VEGAS, NV 89146
Clark County (702) 763-7443
HAZEL SANCHEZ
Behavior Technician
6600 W CHARLESTON BLVD STE 111
LAS VEGAS, NV 89146
Clark County (702) 283-6215
JOSHUA MATTA
Behavior Technician
6600 W CHARLESTON BLVD STE 111
LAS VEGAS, NV 89146
Clark County (702) 283-6215

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Davita Jackson-clark's NPI number?

The NPI number for Davita Jackson-clark is 1871018176. It was assigned to this individual provider in the NPPES registry on August 8, 2017.

Where is Davita Jackson-clark located?

Davita Jackson-clark practices at 6600 W Charleston Blvd Ste 111, Las Vegas, NV 89146. The listed phone number is (702) 763-7443.

What is Davita Jackson-clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Davita Jackson-clark was last updated on December 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.