KIM TATUM (NPI# 1073005419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073005419 |
| Entity Type | Individual |
| Full Name | KIM TATUM |
| Credential | APRN |
| Practice Address |
4500 W Oakey Blvd Las Vegas NV 89102-1527 |
| Mailing Address |
Po Box 98978 Las Vegas NV 89193-8978 |
| Practice Telephone | 7028735110 |
| Practice Fax Number | 7028738093 |
| Mailing Telephone | 7022163346 |
| Mailing Fax Number | 7026716883 |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2018-12-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN002919 | NV | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | STATE LICENSE | APRN002919 | 01 |
| NV | 1073005419 | 05 |
| Street Address |
4500 W OAKEY BLVD |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89102-1527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952372898 | Romeo Rosales | Physician Assistant | 4500 W Oakey Blvd, Las Vegas, NV 89102-1527 | 2006-01-30 |
| 1578060042 | Denese A Williams | Nurse Practitioner | 4500 W Oakey Blvd, Las Vegas, NV 89102 | 2018-04-10 |
| 1326405408 | Benjamin Cabasada Jr. | Nurse Practitioner | 4500 W Oakey Blvd, Las Vegas, NV 89102-1527 | 2016-01-21 |
| 1376880708 | Anthony John Marlon | Physician Assistant | 4500 W Oakey Blvd, Las Vegas, NV 89102-1527 | 2013-01-04 |
| 1295819126 | Daulat Community Family Doctors Ltd | Family Medicine | 4500 W Oakey Blvd, Las Vegas, NV 89102 | 2006-10-25 |
| 1235226770 | Girish H Daulat | Internal Medicine | 4500 W Oakey Blvd, Las Vegas, NV 89102 | 2006-10-06 |
| 1861589301 | Michael A Yabut | Physician Assistant | 4500 W Oakey Blvd, Las Vegas, NV 89102 | 2006-10-06 |
| 1992758726 | Robert J. Lang | Family Medicine | 4500 W Oakey Blvd, Las Vegas, NV 89102 | 2006-05-19 |
| 1205809720 | Paul Leyva Hamor | Internal Medicine | 4500 W Oakey Blvd, Las Vegas, NV 89102-1527 | 2006-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851998397 | Natasha Moore | Technician | 3210 W Charleston Suite 2, Las Vegas, NV 89102 | 2020-10-07 |
| 1568077113 | Zulma Yaneth Tervizo Lopez | Technician | 455 W Oakey Blvd, Ste 111, Las Vegas, NV 89102 | 2020-09-10 |
| 1922629765 | Bianca Vaudreuil | Religious Nonmedical Practitioner | 3210 W Charleston Ste 2, Las Vegas, NV 89102 | 2020-05-04 |
| 1720608052 | Angelica Gutierrez | Technician | Vegas Compassionate Care ; 2820 W. Charleston Blvd B-21, Las Vegas, NV 89102 | 2020-04-16 |
| 1396370680 | Juana Maria Hernandez | Technician | 2881 S. Valley View Blvd, Suite #6, Las Vegas, NV 89102 | 2020-03-06 |
| 1609409648 | Janie Washington | Technician | 3210 W Charleston Blvd. Suite 2, Las Vegas, NV 89102 | 2020-02-18 |
| 1447893185 | Maria Josefina Castaneda | Technician | 2881 S. Valley View Blvd Suite #6, Los Vegas, NV 89102 | 2019-10-25 |
| 1427608777 | Virginia Hernandez Tolentino | Technician | 4550 W Oakley Blvd, Suite 101 A, Las Vegas, NV 89102 | 2019-09-18 |
| 1972153872 | Gladiola Cardoza Quinones | Technician | 2881 S. Valley View Blvd #6, Las Vegas, NV 89102 | 2019-09-13 |
| 1801445572 | Rafael Roberto Gonzalez Palomino | Homemaker | 4550 W. Oakey Blvd, Suite 111-0, Las Vegas, NV 89102 | 2019-09-05 |
| Find all providers in zip 89102 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396651 | Alma F Talavera | Nurse Practitioner | 5982 Juniper Falls Ave, Las Vegas, NV 89130-2827 | 2020-11-06 |
| 1154922300 | Reynaly Campos | Nurse Practitioner | 10680 Spruce Bough St, Las Vegas, NV 89183-4631 | 2020-11-04 |
| 1811596463 | Carolina Salaberrios | Nurse Practitioner | 8440 W Lake Mead Blvd Ste 111, Las Vegas, NV 89128-7648 | 2020-10-23 |
| 1851990840 | John Marius Agravio Tolentino | Nurse Practitioner | 3557 Winter Wren St, Las Vegas, NV 89122-3539 | 2020-10-21 |
| 1811596760 | Emmelyn Pineda Rivas | Nurse Practitioner | 7852 Lovely Pine Pl, Las Vegas, NV 89143-4431 | 2020-10-21 |
| 1659979052 | Francis Torres | Nurse Practitioner | 10010 Fort Pike St, Las Vegas, NV 89178-7543 | 2020-10-16 |
| 1144828849 | Julio Arvie Mata Madarazo Jr. | Nurse Practitioner | 6284 Canvasback Ave, Las Vegas, NV 89122-3545 | 2020-10-14 |
| 1104424076 | Khelsey Macaspac | Nurse Practitioner | 6446 Dunns River St, Las Vegas, NV 89166-8064 | 2020-10-13 |
| 1912505199 | Angelica Villahermosa | Nurse Practitioner | 8115 Dancing Bull Ct, Las Vegas, NV 89139-6702 | 2020-10-11 |
| 1467050625 | Ruby Borja | Nurse Practitioner | 7329 Perkins Hill St, Las Vegas, NV 89166-6505 | 2020-10-10 |
| Find all providers in LAS VEGAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.