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NPI Code Detail

MEDICARE: JANICE SPENCE WILMOT APRN

MEDICARE: JANICE SPENCE WILMOT 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
1163W00000XRegistered Nurse24423AK
2163W00000XRegistered Nurse1-029211AL
3163W00000XRegistered NurseRN60377NV
4363LW0102XWomen's Health Nurse Practitioner836AK
5363LW0102XWomen's Health Nurse Practitioner1-029211AL
6363LW0102XWomen's Health Nurse PractitionerTAPN700482NV
7363L00000XNurse PractitionerAPN001099NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164412086
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANICE SPENCE WILMOT APRN
Provider Business Mailing Address
First Line : 6529 FORZA CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89131-3150
Country : US
Telephone Number : 702-658-4250
Fax Number :
Provider Business Practice Location Address
First Line : 6529 FORZA CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89131-3150
Country : US
Telephone Number : 702-658-4250
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2005
Last Update Date : 05/30/2016

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Directions to “ JANICE SPENCE WILMOT APRN” Practice Location

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