Healthcare Provider Details

I. General information

NPI: 1356003214
Provider Name (Legal Business Name): JESSICA LYN JANAS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2021
Last Update Date: 10/08/2021
Certification Date: 10/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 IRONWOOD DR STE 2102
MINDEN NV
89423-5180
US

IV. Provider business mailing address

802 RIVER KNOLLS CT
DAYTON NV
89403-9045
US

V. Phone/Fax

Practice location:
  • Phone: 775-445-7745
  • Fax:
Mailing address:
  • Phone: 775-220-5365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number847210
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN69790
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: