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NPI Code Detail

MEDICARE: JAZZLYN KIRKLAND

MEDICARE:   JAZZLYN  KIRKLAND
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1649536491
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAZZLYN KIRKLAND
Provider Business Mailing Address
First Line : 648 POANA AVE
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-7694
Country : US
Telephone Number : 702-677-5362
Fax Number :
Provider Business Practice Location Address
First Line : 648 POANA AVE
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-7694
Country : US
Telephone Number : 702-677-5362
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2012
Last Update Date : 04/05/2012

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Directions to “ JAZZLYN KIRKLAND ” Practice Location

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