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NPI Code Detail

MEDICARE: JESSICA DELANEY

MEDICARE: JESSICA DELANEY
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
1183500000XPharmacist18858NV
2183500000XPharmacistS021164AZ

General Provider Information

NPI Number : 1962874776
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA DELANEY
Provider Business Mailing Address
First Line : 9420 W LAKE MEAD BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89134-8312
Country : US
Telephone Number : 702-363-5247
Fax Number :
Provider Business Practice Location Address
First Line : 5888 W SUNSET RD
Second Line : #200
City : LAS VEGAS
State : NV
Zip : 89118-3452
Country : US
Telephone Number : 702-889-8274
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2015
Last Update Date : 10/21/2015

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Directions to “ JESSICA DELANEY ” Practice Location

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