MEDICARE: JEREMIAH UMEH

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	821083	NV
2	363LF0000X	Family Nurse Practitioner	821083	NV
3	363LF0000X	Family Nurse Practitioner	95012920	CA

General Provider Information

NPI Number	:	1225690449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEREMIAH UMEH

Provider Business Mailing Address
First Line	:	9711 MOUNT KENYON ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-4898
Country	:	US
Telephone Number	:	310-500-9312
Fax Number	:	725-863-9247

Provider Business Practice Location Address
First Line	:	9711 MOUNT KENYON ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-4898
Country	:	US
Telephone Number	:	310-500-9312
Fax Number	:	725-863-9247

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

Provider Enumeration Date	:	07/09/2019
Last Update Date	:	01/12/2026

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Directions to “ JEREMIAH UMEH ” Practice Location

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