| Lln02 Llc | |
|
42 Megan Dr Henderson NV 89074-2774 | |
| (405) 881-6822 | |
| Not Available |
| Full Name | Lln02 Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 42 Megan Dr, Henderson, Nevada |
| Authorized Official Name and Position | Lena Nguyen (OWNER) |
| Authorized Official Contact | 4058816822 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lln02 Llc 42 Megan Dr Henderson NV 89074-2774 Ph: (405) 881-6822 | Lln02 Llc 42 Megan Dr Henderson NV 89074-2774 Ph: (405) 881-6822 |
| NPI Number | 1508573676 |
|---|---|
| Provider Enumeration Date | 10/28/2022 |
| Last Update Date | 01/25/2023 |
| Medicare PECOS PAC ID | 5395101604 |
|---|---|
| Medicare Enrollment ID | O20230511001682 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508573676 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Manal Jourdan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942766001 PECOS PAC ID: 8921341629 Enrollment ID: I20190521001958 |
| Provider Name | Anna Marie Grace Maniebo Kastner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801485347 PECOS PAC ID: 6002215043 Enrollment ID: I20210525002014 |
| Provider Name | Lena L Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205470911 PECOS PAC ID: 6305269390 Enrollment ID: I20211005001591 |
| Provider Name | Amber Ashley Sweat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851033849 PECOS PAC ID: 3375992548 Enrollment ID: I20231213001557 |
| Provider Name | Akisha Toussaint |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760026736 PECOS PAC ID: 8123550720 Enrollment ID: I20241021004118 |
| Provider Name | Ciara Lynn Richman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184458358 PECOS PAC ID: 9638608169 Enrollment ID: I20250128003507 |
| Provider Name | James Vir Abrenica Sales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861208035 PECOS PAC ID: 2062942774 Enrollment ID: I20250211002164 |
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