MEDICARE: JACQUELINE EDWARDS

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	103TR0400X	Rehabilitation Psychologist

General Provider Information

NPI Number	:	1487918595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE EDWARDS

Provider Business Mailing Address
First Line	:	PO BOX 335613
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89033-5613
Country	:	US
Telephone Number	:	702-353-2467
Fax Number	:

Provider Business Practice Location Address
First Line	:	370 CASA NORTE DR UNIT 2064
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-3344
Country	:	US
Telephone Number	:	702-353-2467
Fax Number	:

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

Provider Enumeration Date	:	07/03/2012
Last Update Date	:	07/03/2012

Similar Medicare Providers

1992260434 — SANDRA MARIA BELARDO-RODRIGUEZ
Practice Location Address:

3344 GROUSE HOUSE LN
NORTH LAS VEGAS, NV
89084-2351

Practice Phone: 702-468-1570
Practice Fax:

1851453625 — DR. GILBERT K. LEHR OD
Practice Location Address:

778 US HIGHWAY 1
NORTH BRUNSWICK, NJ
08902-3344

Practice Phone: 732-828-6033
Practice Fax: 732-846-4455

1437297058 — OPTICAL INSIGHT
Practice Location Address:

778 US HIGHWAY 1
NORTH BRUNSWICK, NJ
08902-3344

Practice Phone: 732-828-3937
Practice Fax: 732-846-4455

1851191415 — KENYETTA GRAVES
Practice Location Address:

75 RIVER NORTH CT
COVINGTON, GA
30016-3344

Practice Phone: 678-933-8586
Practice Fax:

1629065842 — SEEMA ANJUM MD
Practice Location Address:

3599 S EASTERN AVE
LAS VEGAS, NV
89169-3344

Practice Phone: 702-733-9230
Practice Fax: 702-733-9243

1174613640 — TOMASZ WOLOSZYN MD
Practice Location Address:

4700 LAS VEGAS BLVD N , SUITE 3-3344
NELLIS AFB, NV
89191-6600

Practice Phone: 702-653-1110
Practice Fax:

Directions to “ JACQUELINE EDWARDS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.