MEDICARE: JENNIFER KAWI NP

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	000782	NV
2	363LF0000X	Family Nurse Practitioner	T700202	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	:	1972749588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER KAWI NP

Provider Business Mailing Address
First Line	:	2316 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2149
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3343 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-3312
Country	:	US
Telephone Number	:	702-731-0909
Fax Number	:	702-711-1020

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

Provider Enumeration Date	:	01/02/2009
Last Update Date	:	08/28/2024

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