MEDICARE: MS. JOSEPHINE ANNE SCIACCA APN FNP

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	F333641-1	NY
2	363LF0000X	Family Nurse Practitioner	APN00531	NV

General Provider Information

NPI Number	:	1174543813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOSEPHINE ANNE SCIACCA APN FNP

Provider Business Mailing Address
First Line	:	PO BOX 98978
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89193-8978
Country	:	US
Telephone Number	:	702-216-3346
Fax Number	:	702-671-6883

Provider Business Practice Location Address
First Line	:	210 N SANDHILL BLVD
Second Line	:
City	:	MESQUITE
State	:	NV
Zip	:	89027-4789
Country	:	US
Telephone Number	:	702-345-5000
Fax Number	:	702-345-2000

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	09/13/2013

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