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General NPI Number Information
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NPI Number | 1780270280
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Entity Type | Individual
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Provider Name | JENNY B NATION FNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/18/2020
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 611 NATIONAL AVE
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City | LAS VEGAS
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State | NM
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Zip | 87701-4243
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Country | US
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Telephone | 505-426-0700
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Fax | 505-426-0702
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Provider Business Mailing Address
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Address Line | 611 NATIONAL AVE
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City | LAS VEGAS
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State | NM
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Zip | 87701-4243
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Country | US
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Telephone | 505-426-0070
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Fax | 505-426-0702
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | CNP-62327
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 62327
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License Number State | NM
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