MEDICARE: MS. JEWEL ELYSSE ROCK APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	861120	NV

General Provider Information

NPI Number	:	1104535715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JEWEL ELYSSE ROCK APRN

Provider Business Mailing Address
First Line	:	400 N STEPHANIE ST STE 300
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89014-6692
Country	:	US
Telephone Number	:	702-952-3350
Fax Number	:	702-952-3365

Provider Business Practice Location Address
First Line	:	400 N STEPHANIE ST STE 300
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89014-6692
Country	:	US
Telephone Number	:	702-435-2930
Fax Number	:	702-435-2931

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2022
Last Update Date	:	08/13/2025

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