MEDICARE: JANICE SPENCE WILMOT 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	163W00000X	Registered Nurse	24423	AK
2	163W00000X	Registered Nurse	1-029211	AL
3	163W00000X	Registered Nurse	RN60377	NV
4	363LW0102X	Women's Health Nurse Practitioner	836	AK
5	363LW0102X	Women's Health Nurse Practitioner	1-029211	AL
6	363LW0102X	Women's Health Nurse Practitioner	TAPN700482	NV
7	363L00000X	Nurse Practitioner	APN001099	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164412086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANICE SPENCE WILMOT APRN

Provider Business Mailing Address
First Line	:	6529 FORZA CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-3150
Country	:	US
Telephone Number	:	702-658-4250
Fax Number	:

Provider Business Practice Location Address
First Line	:	6529 FORZA CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-3150
Country	:	US
Telephone Number	:	702-658-4250
Fax Number	:

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

Provider Enumeration Date	:	10/22/2005
Last Update Date	:	05/30/2016

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Directions to “ JANICE SPENCE WILMOT APRN” Practice Location

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