Provider Demographics
NPI:1609600915
Name:ALSMADI, JEHAN AHMED
Entity type:Individual
Prefix:
First Name:JEHAN
Middle Name:AHMED
Last Name:ALSMADI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4440 S EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-7825
Mailing Address - Country:US
Mailing Address - Phone:702-353-1143
Mailing Address - Fax:702-444-4877
Practice Address - Street 1:7358 EMERALD GLOW ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-1303
Practice Address - Country:US
Practice Address - Phone:702-353-1143
Practice Address - Fax:702-444-4877
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker