MEDICARE: STEPHANIE JACKSON

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	103K00000X	Behavior Analyst		NV

General Provider Information

NPI Number	:	1376955294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE JACKSON

Provider Business Mailing Address
First Line	:	6131 ALPINE TREE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-6854
Country	:	US
Telephone Number	:	702-708-7923
Fax Number	:

Provider Business Practice Location Address
First Line	:	6131 ALPINE TREE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-6854
Country	:	US
Telephone Number	:	702-708-7923
Fax Number	:

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

Provider Enumeration Date	:	05/27/2014
Last Update Date	:	05/27/2014

Similar Medicare Providers

1982101358 — GENESIS VIDA HEALTH SERVICES
Practice Location Address:

6075 SILKEN SADDLE ST
NORTH LAS VEGAS, NV
89031-6854

Practice Phone: 702-472-6231
Practice Fax:

1265385678 — SHANTARA BOYD
Practice Location Address:

8180 S RAINBOW BLVD UNIT 343
LAS VEGAS, NV
89139-8004

Practice Phone: 678-633-8579
Practice Fax:

1811735970 — TAMARA QUIANA HILLIARD
Practice Location Address:

8317 BRILLIANT RUBY CT
LAS VEGAS, NV
89139-7135

Practice Phone: 760-819-2792
Practice Fax:

1508710120 — JANELE VILLOSO
Practice Location Address:

5155 BLUE DIAMOND ROAD , SUITE 102 PMB 1043
LAS VEGAS, NV
89139

Practice Phone: 702-688-9500
Practice Fax:

1740550078 — CHESTER C. ROBERT WHITLEY IV P.A.-C
Practice Location Address:

4517 BLUE DIAMOND RD
LAS VEGAS, NV
89139-7620

Practice Phone: 725-258-2982
Practice Fax: 877-709-4341

1518819358 — CHARLOTTE P BELTRAN RN
Practice Location Address:

4817 SEQUOIA TREE AVE
LAS VEGAS, NV
89139-7646

Practice Phone: 702-338-0632
Practice Fax:

Directions to “ STEPHANIE JACKSON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.