MEDICARE: JAN INA LAMBERTE GONZALES DNP, APRN, PMHNP-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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	901554	NV

General Provider Information

NPI Number	:	1982532529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAN INA LAMBERTE GONZALES DNP, APRN, PMHNP-BC

Provider Business Mailing Address
First Line	:	4445 WESTERN FRONT ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-3335
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4505 S MARYLAND PKWY # 453018
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89154-9900
Country	:	US
Telephone Number	:	702-895-3371
Fax Number	:

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

Provider Enumeration Date	:	05/13/2026
Last Update Date	:	05/13/2026

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