MEDICARE: DR. JAMEY E STEPHENS DNP, FNP-C

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	363LF0000X	Family Nurse Practitioner	410577	CA
2	363LF0000X	Family Nurse Practitioner	APN001098	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588694046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMEY E STEPHENS DNP, FNP-C

Provider Business Mailing Address
First Line	:	6900 NORTH PECOS
Second Line	:	VA SOUTHERN NEVADA
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89086-8402
Country	:	US
Telephone Number	:	702-791-9030
Fax Number	:

Provider Business Practice Location Address
First Line	:	2316 W CHARLESTON BLVD
Second Line	:	SUITE 259
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2149
Country	:	US
Telephone Number	:	702-370-8436
Fax Number	:

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

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	02/05/2015

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