Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Jerrell De'Andre Roberts

Individual provider Rehabilitation Practitioner · NPI 1003195488

Mr. Jerrell De'Andre Roberts is a Rehabilitation Practitioner in North las Vegas, Nevada. Practices as a sole proprietor. Licensed in Nevada.

Licensed in
NV
In the registry since
2011
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Practice location Address checks out

2704 Prospector Mine Ave
North las Vegas, NV 89031-1188
Phone: (702) 647-5300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Rehabilitation Practitioner (primary) Taxonomy 225400000X (NV)

Record details

NPI number1003195488
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 16, 2011
Last updated in NPPESSeptember 16, 2011

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