Individual
DR. JESSIE M PICENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2820 W CHARLESTON BLVD STE 33, LAS VEGAS, NV 89102-1934
(702) 880-1558
Mailing address
2820 W CHARLESTON BLVD STE 33, LAS VEGAS, NV 89102-1934
(702) 880-1558
(702) 870-6821
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
14024
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578602579
—
NV
05
—
630186
—
AZ
Enumeration date
02/06/2007
Last updated
07/08/2020
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