Kittleson, Jeanie Marie
Kittleson, Jeanie Marie is an sole proprietor health care provider with primary practice located at St Rose Dominican De Lima 102 E Lake Mead Pkwy, Henderson NV 89015. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Kittleson, Jeanie Marie can be contacted via phone (702) 616-4600.Contact Information
Primary practice address
St Rose Dominican De Lima 102 E Lake Mead Pkwy
Henderson NV 89015
Phone: (702) 616-4600
Fax: (702) 616-4311
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA833 | Nevada |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA9114559 | Florida |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA833 | Nevada |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | Nevada | |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA833 | Nevada |
Profile Details
| NPI number | 1164559415 |
|---|---|
| LBN Legal business name | Kittleson, Jeanie Marie |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 27th, 2007 |
| Last updated | Aug 31st, 2021 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164559415 | NPPES |
| Nevada | MEDICAID | 100503035 |
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