Benjamin, Jessica Leeann

Benjamin, Jessica Leeann is an sole proprietor health care provider with primary practice located at 2525 Donna St Apt D , North Las Vegas NV 89030-5571. She recently has only one registered license in Agencies / Program of All-Inclusive Care for the Elderly (PACE) Provider Organization, which is considered as her primary health care specialty. Benjamin, Jessica Leeann can be contacted via phone (909) 991-9464.

Contact Information

Primary practice address
2525 Donna St Apt D North Las Vegas NV 89030-5571
Phone: (909) 991-9464
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Agencies / Program of All-Inclusive Care for the Elderly (PACE) Provider Organization 251T00000X 00016261488072701238 Nevada

Profile Details

NPI number 1881308393
LBN Legal business name Benjamin, Jessica Leeann
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 9th, 2023
Last updated Jan 9th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881308393 NPPES
Nevada MEDICAID 120027855

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