MEDICARE: JENNA DRAMISE PA-C

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	363AS0400X	Surgical Physician Assistant	PA2717	NV

General Provider Information

NPI Number	:	1083288104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA DRAMISE PA-C

Provider Business Mailing Address
First Line	:	PO BOX 2168
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89702-2168
Country	:	US
Telephone Number	:	775-445-6622
Fax Number	:

Provider Business Practice Location Address
First Line	:	1525 VISTA LN STE 100
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89703-4633
Country	:	US
Telephone Number	:	775-445-6622
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2021
Last Update Date	:	12/22/2022

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Directions to “ JENNA DRAMISE PA-C” Practice Location

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