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NPI Code Detail

MEDICARE: REENA JOHN APN

MEDICARE: REENA JOHN APN
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
1363L00000XNurse PractitionerAPN001068NV
2363L00000XNurse PractitionerAPRN001068NV
3363LF0000XFamily Nurse PractitionerAPRN001068NV

General Provider Information

NPI Number : 1801042528
Entity Type Code : Individual
Provider Name (Legal Business Name) : REENA JOHN APN
Provider Business Mailing Address
First Line : 5233 S EASTERN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-2311
Country : US
Telephone Number : 702-878-9500
Fax Number : 702-796-8502
Provider Business Practice Location Address
First Line : 5233 S EASTERN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-2311
Country : US
Telephone Number : 702-878-9500
Fax Number : 702-878-8993
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2008
Last Update Date : 10/03/2024

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