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NPI Code Detail

MEDICARE: MRS. JOCELYN LEONOR SEGOVIA PAC

MEDICARE: MRS. JOCELYN LEONOR SEGOVIA PAC
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
1363A00000XPhysician AssistantPA825NV

Other Identifiers

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

General Provider Information

NPI Number : 1215991997
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JOCELYN LEONOR SEGOVIA PAC
Provider Business Mailing Address
First Line : 3157 N RAINBOW BLVD # 518
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-4578
Country : US
Telephone Number : 702-386-4700
Fax Number : 702-386-4701
Provider Business Practice Location Address
First Line : 7220 S CIMARRON RD STE 270
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-2160
Country : US
Telephone Number : 702-912-4100
Fax Number : 702-386-4701
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2006
Last Update Date : 02/08/2021

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Directions to “ MRS. JOCELYN LEONOR SEGOVIA PAC” Practice Location

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