LIFE BREAKTHROUGH (NPI# 1386163756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386163756 |
| Entity Type | Organization |
| Organization Name | LIFE BREAKTHROUGH |
| Practice Address |
10885 S Eastern Ave Henderson NV 89052-5857 |
| Mailing Address |
11740 Villa Malaparte Ave Las Vegas NV 89138-6013 |
| Practice Telephone | 7028951883 |
| Mailing Telephone | 7028951883 |
| Enumeration Date | 2017-09-16 |
| Last Update Date | 2017-09-16 |
| Authorized Official Name | LESLIE KALYN (PRESIDENT) |
| Authorized Official Telephone | 7028951883 |
| Authorized Official Credential | DNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | APRN001086 | NV | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | APRN LICENSE | APRN001086 | 01 |
| Street Address |
10885 S EASTERN AVE |
| City | HENDERSON |
| State | NV |
| Zip Code | 89052-5857 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740673029 | Alejandro Jimenez Incera | Nurse Practitioner | 10885 S Eastern Ave, Suite 100, Henderson, NV 89052-5857 | 2015-03-11 |
| 1134654866 | Quiamzon Aesthetic and Concierge Healthcare | Nurse Practitioner | 10885 S Eastern Ave, Suite 100, Henderson, NV 89052-5857 | 2017-05-01 |
| 1447794466 | Incera LLC | Preventive Medicine | 10885 S Eastern Ave, #100, Henderson, NV 89052-5857 | 2016-12-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740889112 | Nathan Michael Nasternak | Physical Therapist | 750 Coronado Center Drive, Suite 140, 2212, Henderson, NV 89052 | 2020-10-18 |
| 1558987180 | Braxton Chad Storm | Counselor | 2990 W. Sundridge Heights Pkwy, Suite #140, Henderson, NV 89052 | 2020-06-19 |
| 1558996546 | The Eye Doctor At St. Rose LLC | Eyewear Supplier (Equipment, not the service) | 2645 St. Rose Parkway, Suite C-110, Henderson, NV 89052 | 2020-03-10 |
| 1770138521 | Quinn Dentists of St. Rose, PC | Dentist | 3519 St Rose Parkway, Ste 110, Henderson, NV 89052 | 2019-08-08 |
| 1346802568 | Rickie Kwong Chin Jr. | Optometrist | 695 S. Green Valley Pkwy, Henderson, NV 89052 | 2019-07-08 |
| 1134695646 | Nu Smiles, LLC | Clinic/Center | 2810 W. Horizon Ridge Parkway, Suite #110, Henderson, NV 89052 | 2018-10-23 |
| 1003393497 | Katherine Lee Villarreal | Physical Therapist | 2930 W Horizon Pkwy, Suite 205, Henderson, NV 89052 | 2018-07-27 |
| 1790281889 | Vicki Lorraine Schmidt | Nurse Practitioner | 2900 W. Horizon Ridge Pkwy, Suite 101, Henderson, NV 89052 | 2018-04-05 |
| 1326566969 | Shelby Schiller | Social Worker | 3051 W Horizon Ridge Pkwy Ste 104a, Henderson, NV 89052 | 2017-09-04 |
| 1639696826 | Pca Ventures, LLC | Technician | 2656 Soda Butte Court, Henderson, NV 89052 | 2017-08-28 |
| Find all providers in zip 89052 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699376558 | Kody Brett Allard | Nurse Practitioner | 1681 Keepsake Ave, Henderson, NV 89014-7562 | 2020-11-05 |
| 1306495080 | Rodelyn Arceo | Nurse Practitioner | 2405 W Horizon Ridge Pkwy Ste 100, Henderson, NV 89052-2718 | 2019-09-05 |
| 1972165421 | Deaconess Clinic Inc | Nurse Practitioner | 1305 N Elm St Ste G, Henderson, KY 42420-2783 | 2019-07-05 |
| 1811456486 | Genica Felise Gelson | Nurse Practitioner | 2839 St. Rose Parkway, Ste. 160, Henderson, NV 89052-4849 | 2019-03-13 |
| 1306310354 | Noni Hayman | Nurse Practitioner | 1769 Beechnut Ave, Henderson, NV 89074-0955 | 2019-01-13 |
| 1659840270 | Ronnie Malalay Bordador | Nurse Practitioner | 715 Mall Ring Cir Ste 202, Henderson, NV 89014-6667 | 2018-11-14 |
| 1790281889 | Vicki Lorraine Schmidt | Nurse Practitioner | 2900 W. Horizon Ridge Pkwy, Suite 101, Henderson, NV 89052 | 2018-04-05 |
| 1528566460 | Gloria Santiaguel Mandel | Nurse Practitioner | 191 Mescalero Trl, Henderson, NV 89074-1037 | 2018-01-25 |
| 1821500141 | Samantha Leigh Sylvia | Nurse Practitioner | 568 Ruin Creek Rd Ste 6, Henderson, NC 27536-5921 | 2017-10-26 |
| 1144739707 | Dignity Health Medical Group Nevada, LLC | Nurse Practitioner | 1701 N Green Valley Pkwy Ste 10a, Henderson, NV 89074-5991 | 2017-09-27 |
| Find all providers in HENDERSON | ||||
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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.