MEDICARE: JEANNELL PEREZ DURAN

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	1041C0700X	Clinical Social Worker		NV

General Provider Information

NPI Number	:	1356275598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNELL PEREZ DURAN

Provider Business Mailing Address
First Line	:	4344 W CHEYENNE AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-2484
Country	:	US
Telephone Number	:	702-675-6314
Fax Number	:	702-476-9697

Provider Business Practice Location Address
First Line	:	4344 W CHEYENNE AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-2484
Country	:	US
Telephone Number	:	702-675-6314
Fax Number	:	702-476-9697

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

Provider Enumeration Date	:	06/11/2026
Last Update Date	:	06/11/2026

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Directions to “ JEANNELL PEREZ DURAN ” Practice Location

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