MEDICARE: JETHRO APOSTOL FNP-C

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	821129	NV

General Provider Information

NPI Number	:	1467851782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JETHRO APOSTOL FNP-C

Provider Business Mailing Address
First Line	:	7705 BLUE MEADOW AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-8408
Country	:	US
Telephone Number	:	702-413-2243
Fax Number	:

Provider Business Practice Location Address
First Line	:	145 E WARM SPRINGS RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4101
Country	:	US
Telephone Number	:	702-659-9090
Fax Number	:

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

Provider Enumeration Date	:	08/22/2014
Last Update Date	:	08/23/2022

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Directions to “ JETHRO APOSTOL FNP-C” Practice Location

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