Provider Demographics
NPI:1588694046
Name:STEPHENS, JAMEY E (DNP, FNP-C)
Entity type:Individual
Prefix:DR
First Name:JAMEY
Middle Name:E
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 NORTH PECOS
Mailing Address - Street 2:VA SOUTHERN NEVADA
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89086-8402
Mailing Address - Country:US
Mailing Address - Phone:702-791-9030
Mailing Address - Fax:
Practice Address - Street 1:2316 W CHARLESTON BLVD
Practice Address - Street 2:SUITE 259
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2149
Practice Address - Country:US
Practice Address - Phone:702-370-8436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA410577363LF0000X
NVAPN001098363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1588694046Medicaid
NVBV257XMedicare PIN
NVBV257YMedicare PIN