Provider Demographics
NPI:1801115795
Name:JANET WHEBLE PA-C LTD
Entity type:Organization
Organization Name:JANET WHEBLE PA-C LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:R
Authorized Official - Last Name:WHEBLE
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C MPAS
Authorized Official - Phone:702-354-5712
Mailing Address - Street 1:4162 E PATRICK LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3905
Mailing Address - Country:US
Mailing Address - Phone:702-354-5712
Mailing Address - Fax:702-456-1276
Practice Address - Street 1:5564 S FORT APACHE RD STE 120
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-3601
Practice Address - Country:US
Practice Address - Phone:702-354-5712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-18
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
310400000X
NV412363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No310400000XNursing & Custodial Care FacilitiesAssisted Living FacilityGroup - Multi-Specialty