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NPI Code Detail

MEDICARE: ROSE LEIH JUSAYAN APRN

MEDICARE: ROSE LEIH JUSAYAN APRN
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
1363LP2300XPrimary Care Nurse PractitionerAPRN001582NV
2363L00000XNurse PractitionerAPRN001582NV

General Provider Information

NPI Number : 1144657149
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSE LEIH JUSAYAN APRN
Provider Business Mailing Address
First Line : 8550 W CHARLESTON BLVD STE 108
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-9080
Country : US
Telephone Number : 725-210-4900
Fax Number :
Provider Business Practice Location Address
First Line : 7251 W LAKE MEAD BLVD STE 300
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-8380
Country : US
Telephone Number : 702-629-6992
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2013
Last Update Date : 09/20/2023

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Directions to “ ROSE LEIH JUSAYAN APRN” Practice Location

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