Individual
JENNY SUE DEWALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-2273
Mailing address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-2273
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
892078
NV
163WX0003X
Inpatient Obstetric Registered Nurse
892078
NV
367A00000X
Advanced Practice Midwife
Primary
892078
NV
Other
Enumeration date
07/29/2025
Last updated
10/01/2025
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