Individual
MR. IKAIKA K MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
7220 S CIMARRON RD STE 155, LAS VEGAS, NV 89113-2170
(725) 252-8089
(800) 532-0674
Mailing address
7220 S CIMARRON RD STE 155, LAS VEGAS, NV 89113-2170
(725) 252-8089
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
RN80851
HI
363LF0000X
Family Nurse Practitioner
Primary
812685
NV
363LF0000X
Family Nurse Practitioner
APRN-2456
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407349715
—
NV
01
—
812685
STATE LICENSE
NV
Enumeration date
06/11/2018
Last updated
03/19/2024
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