MEDICARE: LAURA JEZIORSKI

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	231H00000X	Audiologist	141	NV
2	237700000X	Hearing Instrument Specialist	245	NV

General Provider Information

NPI Number	:	1578906566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA JEZIORSKI

Provider Business Mailing Address
First Line	:	PO BOX 33534
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-3534
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4000 MEADOWS LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-3108
Country	:	US
Telephone Number	:	702-259-4944
Fax Number	:

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

Provider Enumeration Date	:	04/10/2013
Last Update Date	:	04/10/2013

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Directions to “ LAURA JEZIORSKI ” Practice Location

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