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NPI Code Detail

MEDICARE: EVA JENKINS

MEDICARE: EVA JENKINS
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1316455462
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVA JENKINS
Provider Business Mailing Address
First Line : 5550 W FLAMINGO RD STE A5
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-0135
Country : US
Telephone Number : 702-463-4000
Fax Number : 702-463-4460
Provider Business Practice Location Address
First Line : 5550 W FLAMINGO RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-2334
Country : US
Telephone Number : 702-463-4000
Fax Number : 703-463-4460
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2018
Last Update Date : 01/10/2018

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Directions to “ EVA JENKINS ” Practice Location

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