FESTUS EBONKA (NPI# 1932241007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932241007 |
| Entity Type | Individual |
| Full Name | FESTUS EBONKA |
| Practice Address |
1721 E Charleston Blvd Las Vegas NV 89104-1902 |
| Mailing Address |
1721 E. Charleston Blvd. Las Vegas NV 89104-1902 |
| Practice Telephone | 7025159680 |
| Practice Fax Number | 7026859674 |
| Mailing Telephone | 7025159680 |
| Mailing Fax Number | 7026859674 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2017-09-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN000902 | NV | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
APRN000902 | NV | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1721 E CHARLESTON BLVD |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89104-1902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699391011 | Bright Star Urgent Care | Clinic/Center | 1721 E Charleston Blvd, Las Vegas, NV 89104-1902 | 2020-06-22 |
| 1801412218 | Matthew Okeke, M.d. Ltd | Nurse Practitioner | 1721 E Charleston Blvd, Las Vegas, NV 89104-1902 | 2020-06-22 |
| 1699390427 | Matthew Okeke, M.d. Ltd | Clinic/Center | 1721 E Charleston Blvd, Las Vegas, NV 89104-1902 | 2020-06-08 |
| 1053931576 | Vegas Innovative Psychiatry | Clinic/Center | 1721 E Charleston Blvd, Las Vegas, NV 89104-1902 | 2020-04-24 |
| 1558981068 | Vegas Innovative Psychiatry | Psychologist | 1721 E Charleston Blvd, Las Vegas, NV 89104-1902 | 2020-04-24 |
| 1851933873 | Ebony Relief Charitable Inc. | Community/Behavioral Health | 1721 E Charleston Blvd, Las Vegas, NV 89104-1902 | 2019-10-10 |
| 1104308147 | Nevada Integrated Behavioral Services Inc. | Counselor | 1721 E Charleston Blvd, Las Vegas, NV 89104-1902 | 2018-09-06 |
| 1083158489 | Melisa Stephens | Community Health Worker | 1721 E Charleston Blvd, Las Vegas, NV 89104-1902 | 2016-12-05 |
| 1952852097 | Nevada Integrated Behavioral Services Inc. | Community/Behavioral Health | 1721 E Charleston Blvd, 1721, Las Vegas, NV 89104-1902 | 2016-10-24 |
| 1699225599 | Ebonny Ventures Inc | Clinic/Center | 1721 E Charleston Blvd, 1721, Las Vegas, NV 89104-1902 | 2016-10-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316550635 | Comfort Care Senior Services LLC | In Home Supportive Care | 1601 S Sandhill Rd, 62, Las Vegas, NV 89104 | 2020-08-26 |
| 1508484734 | Accessible Space Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1405 South Mojave Rd, Las Vegas, NV 89104 | 2020-07-14 |
| 1003448333 | Shirley Lauren Valenzona-gianan | Pharmacist | Smith's Pharmacy #318, 4965 East Sahara Avenue, Las Vegas, NV 89104 | 2020-02-05 |
| 1427602713 | Alma Lucia Lozano-vargas | Chore Provider | 1785 E. Sahara Ave. Suite 485, Las Vegas, NV 89104 | 2019-07-25 |
| 1396398947 | Martinez Antuan Coates | Psychologist | 1755 Palm St Bld T Apt147, Las Vegas, NV 89104 | 2019-07-23 |
| 1982171518 | Ian Sande | Occupational Therapist | 1500 West Warm Springs Rd, Las Vegas, NV 89104 | 2018-11-01 |
| 1215436563 | A Better Life In Home Care, LLC | Technician | 1810 East Sahara Avenue, Suite 216, Las Vegas, NV 89104 | 2018-02-01 |
| 1891202016 | Nevada Helping Hands LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1810 E Sahara Ave Ste 143, Las Vegas, NV 89104 | 2018-01-09 |
| 1760901581 | Fannie Bell | Counselor | 1800 E. Sahara Suite 104, Las Vegas, NV 89104 | 2017-09-13 |
| 1386162147 | Jaclyn Mustachio | Social Worker | 1860 E Sahara Ave, Las Vegas, NV 89104 | 2017-08-31 |
| Find all providers in zip 89104 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801404074 | Ibukun Odutola | Nurse Practitioner | 2605 E Flamingo Rd, Las Vegas, NV 89121-5241 | 2020-07-14 |
| 1225652191 | Angela Beth Wilson | Nurse Practitioner | 5440 W Sahara Ave Ste 220, Las Vegas, NV 89146-0355 | 2020-06-05 |
| 1104445394 | Universal Psychiatry LLC | Nurse Practitioner | 270 E Flamingo Rd Unit 122, Las Vegas, NV 89169-0325 | 2020-04-09 |
| 1952931271 | Paramount Healthcare Services Corp | Nurse Practitioner | 10141 Rockridge Peak Ave, Las Vegas, NV 89166-5200 | 2020-01-26 |
| 1730642182 | Aban Medical Services | Nurse Practitioner | 10145 Eagle Haven St, Las Vegas, NV 89141-8781 | 2019-04-11 |
| 1750857728 | Jan Michael Arceo | Nurse Practitioner | 3140 S Rainbow Blvd Ste 401, Las Vegas, NV 89146-6234 | 2018-10-17 |
| 1780110247 | Jon A Failla Aprn Pllc | Nurse Practitioner | 182 Apache Tear Ct, Las Vegas, NV 89123-2996 | 2017-05-03 |
| 1023565074 | Bright Star Nurse Care LLC | Nurse Practitioner | 8337 Fox Brook St, Las Vegas, NV 89139-6755 | 2016-09-07 |
| 1467805119 | Kasey James Dean | Nurse Practitioner | 3321 N Buffalo Dr, Suite 200, Las Vegas, NV 89129-6678 | 2016-07-18 |
| 1558757021 | Martin Binyange | Nurse Practitioner | 320 E Warm Springs Rd Unit 1, Las Vegas, NV 89119-4243 | 2015-04-12 |
| 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.