MEDICARE: JANET WHEBLE PA-C LTD

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	310400000X	Assisted Living Facility
2	363A00000X	Physician Assistant	412	NV

General Provider Information

NPI Number	:	1801115795
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JANET WHEBLE PA-C LTD

Provider Business Mailing Address
First Line	:	4162 E PATRICK LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3905
Country	:	US
Telephone Number	:	702-354-5712
Fax Number	:	702-456-1276

Provider Business Practice Location Address
First Line	:	5564 S FORT APACHE RD STE 120
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-3601
Country	:	US
Telephone Number	:	702-354-5712
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JANET R. WHEBLE
Credential	:	PA-C MPAS
Telephone Number	:	702-354-5712

Provider Enumeration Date	:	05/18/2010
Last Update Date	:	03/29/2019

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