Jaycen Blomquist, DO

Individual provider Active NPI Military Health Care Provider · Nellis Afb, NV

NPI 1023957875 · NPPES record last updated Mar 26, 2026

Key facts

NPI
1023957875
Entity type
Individual (NPI type 1)
Primary specialty
Military Health Care Provider 171000000X
Practice address
4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600
Phone
(702) 653-2273
NPI assigned
Mar 26, 2026
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Osteopathy

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X Yes

Addresses

Primary practice location

4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600

Mailing address

4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600

Other providers in Nellis Afb, NV

All providers in Nellis Afb, NV · Military Health Care Provider in Nevada

Sources for this page

Verify at the official NPI Registry.