MR. IKAIKA K MORENO (NPI# 1407349715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1407349715 |
Entity Type | Individual |
Full Name | MR. IKAIKA K MORENO |
Credential | FNP-BC |
Practice Address |
595 W Lake Mead Pkwy Henderson NV 89015-7015 |
Mailing Address |
Po Box 98978 Las Vegas NV 89193-8978 |
Practice Telephone | 7025665500 |
Practice Fax Number | 7025587238 |
Mailing Telephone | 7022163346 |
Enumeration Date | 2018-06-11 |
Last Update Date | 2019-12-04 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 163WE0003X |
Registered Nurse Specialization: Emergency |
RN80851 | HI | Nursing Service Providers |
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
812685 | NV | Physician Assistants & Advanced Practice Nursing Providers |
N | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN-2456 | HI | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NV | 1407349715 | 05 | |
NV | STATE LICENSE | 812685 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
130 W Naauao St, Hilo, HI 967206707 | 8082806571 | |
1438 Kilauea Ave, Hilo, HI 96720 | 8089699220 | 8089614794 |
5771 S Fort Apache Rd Ste 120, Las Vegas, NV 891485626 | 7026141250 |
Street Address |
595 W LAKE MEAD PKWY |
City | HENDERSON |
State | NV |
Zip Code | 89015-7015 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750383360 | Byron Kilpatrick | Family Medicine | 595 W Lake Mead Pkwy, Henderson, NV 89015-7071 | 2005-08-12 |
1811376908 | Vance Marshal Washington | Family Medicine | 595 W Lake Mead Pkwy, Henderson, NV 89015-7015 | 2015-05-22 |
1497144869 | Yaheiry Urena | Physician Assistant | 595 W Lake Mead Pkwy, Henderson, NV 89015-7015 | 2015-01-22 |
1629412002 | Christina Henry | Family Medicine | 595 W Lake Mead Pkwy, Henderson, NV 89015-7015 | 2013-04-29 |
1679899579 | Demian Gitnacht | Family Medicine | 595 W Lake Mead Pkwy, Henderson, NV 89015-7015 | 2010-04-16 |
1184948135 | Carlos Aaron Kelsey | Physician Assistant | 595 W Lake Mead Pkwy, Henderson, NV 89015 | 2010-03-19 |
1154583938 | Ahoora Payam | Internal Medicine | 595 W Lake Mead Pkwy, Henderson, NV 89015-7015 | 2008-07-02 |
1861600975 | Amanda Justine Hutchinson | Family Medicine | 595 W Lake Mead Pkwy, Henderson, NV 89015-7015 | 2007-05-21 |
1750505095 | Tamika Boulware Phyfer | Physician Assistant | 595 W Lake Mead Pkwy, Henderson, NV 89015-7015 | 2007-04-11 |
1649365289 | Mary Anne Kidwell | Physician Assistant | 595 W Lake Mead Pkwy, Henderson, NV 89015-7015 | 2006-10-03 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225503238 | Holly Abarca | Home Health Aide | 212 Shoshone Ln, Henderson, NV 89015 | 2018-10-05 |
1184111890 | Pain Center of Henderson LLC | Pain Medicine | 98 E. Lake Mead Pkwy. Suite 202, Henderson, NV 89015 | 2018-04-18 |
1124528963 | Edson Jeam Arredondo | Chore Provider | 160 E Horison Dr Ste A, Henderson, NV 89015 | 2018-02-19 |
1558879569 | Robin Harvey | Rehabilitation Practitioner | 203 S. Water St # 200, Henderson, NV 89015 | 2018-01-12 |
1477064368 | Chris Mcdonald | Counselor | 220 E Horizon Drive, Suite H, Henderson, NV 89015 | 2017-10-18 |
1649792565 | David Blake | Case Manager/Care Coordinator | 522 E. Lake Mead Parkway, Suite 5, Henderson, NV 89015 | 2017-07-12 |
1457726135 | Ozioma Chiebuka Nwosu | Nurse Practitioner | 200 E Horizon Dr Ste A, Henderson, NV 89015 | 2015-12-07 |
1770962839 | Myesha Nicole Butler | Counselor | 16 W. Pacific Street, Ste. 2, Henderson, NV 89015 | 2015-05-22 |
1629469424 | Felicia Suberville | Behavioral Analyst | 236 Red Horizon Terrace, Henderson, NV 89015 | 2015-02-16 |
1144618349 | Dinesh Bharwani | Physician Assistant | 270 West Lake Mead Parkway, Southwest Medical Associates, Henderson, NV 89015 | 2014-12-23 |
Find all providers in zip 89015 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083227870 | Raven Nicole Pirtle | Nurse Practitioner | 1245 Glenshiel Dr, Henderson, KY 42420-2529 | 2020-08-31 |
1811509359 | Kristi Lynn Navarette | Nurse Practitioner | 3058 Hushed Sonnet Ave, Henderson, NV 89044-0558 | 2020-08-17 |
1275143711 | Kristyn Cisilino | Nurse Practitioner | 2556 Chateau Clermont St, Henderson, NV 89044-0459 | 2020-08-07 |
1972113363 | Rini Susan Mathews | Nurse Practitioner | 3396 Dalmore St, Henderson, NV 89044-1722 | 2020-07-31 |
1033735014 | Savinder Kaur Virk | Nurse Practitioner | 10747 Shasta Glow Ct, Henderson, NV 89052-8691 | 2020-06-24 |
1811517022 | D Ana Curtis | Nurse Practitioner | 815 Chameleon Star Ave, Henderson, NV 89015-2411 | 2020-04-17 |
1275169013 | Joyce Carlos Damiano | Nurse Practitioner | 2839 Saint Rose Pkwy Ste 130, Henderson, NV 89052-4849 | 2020-03-12 |
1568008878 | Oliver Torrefranca | Nurse Practitioner | 910 Monte Etna Ave, Henderson, NV 89012-2654 | 2019-11-21 |
1568006864 | Melissa Ann Ridella | Nurse Practitioner | 1748 W Horizon Ridge Pkwy, Henderson, NV 89012-4833 | 2019-10-30 |
1245881317 | Edith Borgert | Nurse Practitioner | 3039 W Horizon Ridge Pkwy Ste 110, Henderson, NV 89052-4193 | 2019-09-20 |
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.