BRIANNE WADTKE (NPI# 1194085472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194085472 |
| Entity Type | Individual |
| Full Name | BRIANNE WADTKE |
| Practice Address |
405 Prairie Moon Ave North Las Vegas NV 89084-1257 |
| Practice Telephone | 7025340321 |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2012-05-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1003X |
Military Health Care Provider Specialization: Independent Duty Medical Technicians |
Other Service Providers |
| Street Address |
405 PRAIRIE MOON AVE |
| City | NORTH LAS VEGAS |
| State | NV |
| Zip Code | 89084-1257 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275016677 | Donna Faye Bonner | Technician | 121 Elks Peak Ave., 121 Elks Peak Ave, N. Las Vegas, NV 89084 | 2018-09-11 |
| 1376047662 | Dolly Leticia Diaz | Technician | 7133 Weavers Pl, North Las Vegas, NV 89084 | 2018-03-21 |
| 1649771841 | May Ruth Byrd | Chore Provider | 6638 Cinnabar Coast Lane, Las Vegas, NV 89084 | 2018-02-22 |
| 1841718541 | Tori Tobin | Occupational Therapist | 2550 Nature Park Drive, Ste. 180, North Las Vegas, NV 89084 | 2017-09-01 |
| 1568989986 | Necole Ealy | Day Training/Habilitation Specialist | 6905 Auklet Ln, N Las Vegas, NV 89084 | 2017-08-25 |
| 1871031906 | Mvp Primary Care LLC | Registered Nurse | 6935-104 Aliante Parkway, #509, North Las Vegas, NV 89084 | 2017-02-09 |
| 1679932743 | Melissa Brown | Occupational Therapist | 29 Chastain Park Drive, North Las Vegas, NV 89084 | 2016-02-18 |
| 1598163636 | Taylor Briana Mitchell | Behavioral Analyst | 6929 Puetollano Drive, North Las Vegas, NV 89084 | 2014-12-05 |
| 1801229240 | Faith Thomas | Behavioral Analyst | 634 W Lava Beds Wy, North Las Vegas, NV 89084 | 2013-08-20 |
| 1497028401 | Cornell Williams | Rehabilitation Practitioner | 6616 Lavender Lilly Ln #1, N. Las Vegas, NV 89084 | 2012-02-22 |
| Find all providers in zip 89084 | ||||
| Taxonomy Code | 1710I1003X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Medical Technicians |
| An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians. |
| Notes: Source: Air Force Surgeon General Office [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427525831 | John Varner | Military Health Care Provider | 3832 Prairie Orchid Ave, North Las Vegas, NV 89081-4029 | 2018-10-24 |
| 1235401621 | Jeremy Michael Greeley | Military Health Care Provider | 5221 Puma Ct, North Las Vegas, NV 89031-0704 | 2012-02-01 |
| 1902037344 | Olekachi Jean Thomas | Military Health Care Provider | 5537 Diano Marina Ct, North Las Vegas, NV 89081-4078 | 2009-08-03 |
| 1447480801 | Louis Ruben Naungayan | Military Health Care Provider | 2918 Paradise Hill Ct, North Las Vegas, NV 89031-0539 | 2009-07-20 |
| 1861835944 | Mariane Tolentino | Military Health Care Provider | 2655 E Deer Springs Way, Apt 3118, North Las Vegas, NV 89086-1407 | 2013-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265078257 | Matthew Harrison | Military Health Care Provider | 1421 Airport Rd Ste 100, Boulder City, NV 89005-3659 | 2019-11-25 |
| 1033607478 | Steven Correa | Military Health Care Provider | 4700 Las Vegas Blvd N # 1300, Las Vegas, NV 89191-6600 | 2018-05-01 |
| 1518483320 | Jessica Ann Ewers | Military Health Care Provider | 8701 W Gilmore Ave, Las Vegas, NV 89129-7687 | 2017-08-15 |
| 1306175096 | Ta'wana L Jones | Military Health Care Provider | 1900 Las Vegas Blvd, Las Vegas, NV 89110 | 2009-12-09 |
| 1255560462 | Jordan Lawrence | Military Health Care Provider | 1579 Malmstrom Avenue, Nellis Afb, NV 89191 | 2009-07-09 |
| 1497983332 | Christopher Lee Clark | Military Health Care Provider | 5179 Malmstrom Ave, Nellis Afb, NV 89191-6126 | 2009-06-30 |
| 1225263072 | Adrienne L Clark | Military Health Care Provider | 5154 Ellsworth Ave, Suite 61690, Las Vegas, NV 89191 | 2009-05-22 |
| 1558595785 | Bradley Allen Olson | Military Health Care Provider | 25 Black Wash Way, Henderson, NV 89074-6324 | 2009-05-01 |
| 1699919829 | Joshua Luke Roberts | Military Health Care Provider | 29 Marble Apex Ave, N Las Vegas, NV 89031-6898 | 2009-05-01 |
| 1346483500 | Brandy R Williams | Military Health Care Provider | 9303 Gilcrease Ave, Unit 1207, Las Vegas, NV 89149-0199 | 2009-04-16 |
| Find all providers with the same taxonomy | ||||
| City | NORTH LAS VEGAS |
| Zip Code | 89084 |
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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.