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NPI Code Detail

MEDICARE: TAMPA JILL WARDLOW

MEDICARE: TAMPA JILL WARDLOW
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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1659208379
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMPA JILL WARDLOW
Provider Business Mailing Address
First Line : 2551 S FORT APACHE RD STE 102
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-8700
Country : US
Telephone Number : 702-385-0920
Fax Number :
Provider Business Practice Location Address
First Line : 2551 S FORT APACHE RD STE 102
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-8700
Country : US
Telephone Number : 702-385-0920
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2026
Last Update Date : 05/06/2026

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Directions to “ TAMPA JILL WARDLOW ” Practice Location

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