Individual provider Active NPI

Suzette Bruna Jacobs, PHARMD

  • Pharmacist
  • North Las Vegas, NV
National Provider Identifier
1952686834
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
17642 Issued in NV
Practice address
1445 W Craig Rd
North Las Vegas, NV 89032-0211
Phone
(702) 649-3113
NPI assigned
Oct 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 17642 NV Primary

Addresses

Primary practice location

1445 W Craig Rd
North Las Vegas, NV 89032-0211

Mailing address

1445 W Craig Rd
North Las Vegas, NV 89032-0211
Phone (702) 649-3113

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
17642NVMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1952686834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 W CRAIG RD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890320211",
            "telephone_number": "702-649-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 W CRAIG RD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890320211",
            "telephone_number": "702-649-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "SUZETTE",
        "middle_name": "BRUNA",
        "name_prefix": "Mrs.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-11",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "17642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.