MEDICARE: JCN MEDICAL 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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1104771476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JCN MEDICAL LLC

Provider Business Mailing Address
First Line	:	3601 W SAHARA AVE STE 211
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-5821
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3601 W SAHARA AVE STE 211
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-5821
Country	:	US
Telephone Number	:	702-901-2936
Fax Number	:	702-460-0424

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	J NUNAG
Credential	:
Telephone Number	:	702-901-2935

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/12/2026

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Directions to “JCN MEDICAL LLC ” Practice Location

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