Provider Demographics
NPI:1417467796
Name:JENNIFER CRIBB PLLC
Entity Type:Organization
Organization Name:JENNIFER CRIBB PLLC
Other - Org Name:SAGE HEALTH MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CRIBB
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:702-456-8299
Mailing Address - Street 1:5536 S FORT APACHE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-7687
Mailing Address - Country:US
Mailing Address - Phone:702-456-8299
Mailing Address - Fax:702-722-2558
Practice Address - Street 1:5536 S FORT APACHE RD STE 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-7687
Practice Address - Country:US
Practice Address - Phone:702-456-8299
Practice Address - Fax:702-722-2558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
13992539OtherCAQH