Most Relevant Information
Provider Data
| NPI Number: | 1003250143 |
| Provider Name: | JANN STACEY PICKENS NP |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | APN001525 |
Most Important Dates
| Enumeration Date: | 04/19/2013 |
| Last Updated: | 08/12/2020 |
Provider Practice Location
620 SHADOW LN
LAS VEGAS
NV
891064119
Practice Location Phone/Fax
| Phone: | 7023884506 |
| Fax: | 7023884810 |
Provider Mailing Location
PO BOX 13917
PHILADELPHIA
PA
191013917
Provider Mailing Phone/Fax
| Phone: | 8003550808 |
| Fax: | 6108342862 |