Provider Demographics
NPI:1457864241
Name:LEWIS, JASMINE NICOLE (APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JASMINE
Middle Name:NICOLE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:APRN, FNP-BC
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Mailing Address - Street 1:8906 SPANISH RIDGE AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-1319
Mailing Address - Country:US
Mailing Address - Phone:702-330-3102
Mailing Address - Fax:702-912-4994
Practice Address - Street 1:6850 N DURANGO DR STE 204
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-4596
Practice Address - Country:US
Practice Address - Phone:702-867-1726
Practice Address - Fax:702-396-0245
Is Sole Proprietor?:No
Enumeration Date:2017-11-15
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVAPRN002669363L00000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1457864241Medicaid