MEDICARE: JENNIFER DAWN POWERS FNP- BC

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	363L00000X	Nurse Practitioner	APRN001213	NV

General Provider Information

NPI Number	:	1467763359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER DAWN POWERS FNP- BC

Provider Business Mailing Address
First Line	:	8906 SPANISH RIDGE AVE STE 202
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1319
Country	:	US
Telephone Number	:	702-330-3102
Fax Number	:	702-912-4994

Provider Business Practice Location Address
First Line	:	9810 W SKYE CANYON PARK DR STE 120
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89166-6634
Country	:	US
Telephone Number	:	702-602-5777
Fax Number	:	702-602-5888

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

Provider Enumeration Date	:	06/25/2010
Last Update Date	:	11/17/2022

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