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NPI Code Detail

MEDICARE: JENNIFER CRIBB PLLC

MEDICARE: JENNIFER CRIBB PLLC
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
1261QP2300XPrimary Care Clinic/CenterNV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
113992539OTHERCAQH

General Provider Information

NPI Number : 1417467796
Entity Type Code : Organization
Provider Name (Legal Business Name) : JENNIFER CRIBB PLLC
Provider Business Mailing Address
First Line : 5536 S FORT APACHE RD STE 102
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-7687
Country : US
Telephone Number : 702-456-8299
Fax Number : 702-722-2558
Provider Business Practice Location Address
First Line : 5536 S FORT APACHE RD STE 102
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-7687
Country : US
Telephone Number : 702-456-8299
Fax Number : 702-722-2558
Authorized Official
Title or Position : OWNER
Name : MS. JENNIFER LYNN CRIBB
Credential : APRN
Telephone Number : 702-456-8299
Provider Enumeration Date : 10/02/2017
Last Update Date : 09/19/2025

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