MR. IKAIKA K MORENO


Address: 595 W Lake Mead Pkwy, Henderson, NV 89015-7015
Phone: 7025665500

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
NV 1407349715 05
NV STATE LICENSE 812685 01

Provider Secondary Practice Location

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

Office Location

Street Address 595 W LAKE MEAD PKWY
City HENDERSON
State NV
Zip Code 89015-7015

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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

Competitor

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City HENDERSON
Zip Code 89015

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Dataset Information

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.

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