MEDICARE: JAN MICHAEL ARCEO DNP LLC

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

General Provider Information

NPI Number	:	1750909453
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAN MICHAEL ARCEO DNP LLC

Provider Business Mailing Address
First Line	:	3140 S RAINBOW BLVD STE 401
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-6234
Country	:	US
Telephone Number	:	702-476-4321
Fax Number	:

Provider Business Practice Location Address
First Line	:	3140 S RAINBOW BLVD STE 401
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-6234
Country	:	US
Telephone Number	:	702-476-4321
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JAN MICHAEL ARCEO
Credential	:	DNP
Telephone Number	:	702-476-4321

Provider Enumeration Date	:	07/08/2020
Last Update Date	:	10/21/2020

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