Mrs Jessica Lynn Enders, RD/LD | |
528 Sol De Sandia St, Henderson, NV 89015-6961 | |
(770) 262-5568 | |
Not Available |
Full Name | Mrs Jessica Lynn Enders |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 528 Sol De Sandia St, Henderson, Nevada |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1427280874 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | 34408DI-0 (Nevada) | Primary |
Provider Name | Childrens Lung Specialists |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1518916451 PECOS PAC ID: 5991782971 Enrollment ID: O20040707001042 |
Mailing Address | Practice Location Address |
---|---|
Mrs Jessica Lynn Enders, RD/LD 528 Sol De Sandia St, Henderson, NV 89015-6961 Ph: (770) 262-5568 | Mrs Jessica Lynn Enders, RD/LD 528 Sol De Sandia St, Henderson, NV 89015-6961 Ph: (770) 262-5568 |
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