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NPI Code Detail

MEDICARE: JONA STEAD AGNP, APN-BC

MEDICARE: JONA STEAD AGNP, APN-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
1363LA2200XAdult Health Nurse Practitioner26NJ00636300NJ
2363LG0600XGerontology Nurse Practitioner26NJ00636300NJ
3363LP2300XPrimary Care Nurse Practitioner839722NV

General Provider Information

NPI Number : 1891141552
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONA STEAD AGNP, APN-BC
Provider Business Mailing Address
First Line : 650 N NELLIS BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-5382
Country : US
Telephone Number : 702-790-8000
Fax Number :
Provider Business Practice Location Address
First Line : 650 N NELLIS BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-5382
Country : US
Telephone Number : 702-790-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2016
Last Update Date : 05/10/2021

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Directions to “ JONA STEAD AGNP, APN-BC” Practice Location

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