Individual
JANN STACEY PICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
620 SHADOW LN, LAS VEGAS, NV 89106-4119
(702) 388-4506
(702) 388-4810
Mailing address
PO BOX 13917, PHILADELPHIA, PA 19101-3917
(800) 355-0808
(610) 834-2862
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APN001525
NV
363L00000X
Nurse Practitioner
Primary
APRN001525
NV
Other
Enumeration date
04/19/2013
Last updated
08/12/2020
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