GWENDOLYN IVY (NPI# 1053962522) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053962522 |
| Entity Type | Individual |
| Full Name | GWENDOLYN IVY |
| Practice Address |
5412 Boulder Hwy Las Vegas NV 89122-6039 |
| Mailing Address |
9623 Bighorn Ranch Ave Las Vegas NV 89148-4221 |
| Practice Telephone | 7022917121 |
| Mailing Telephone | 7736561525 |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2019-09-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
812191 | NV | Nursing Service Providers |
| Street Address |
5412 BOULDER HWY |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89122-6039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346432374 | Pamela Hollis | Social Worker | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2007-08-14 |
| 1780283374 | Kelly Ann Waddilove | Case Manager/Care Coordinator | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-10-23 |
| 1942809157 | Christopher David Burns | Case Manager/Care Coordinator | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-10-19 |
| 1518564533 | Aimee Hollaway De Jesus | Counselor | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-10-02 |
| 1427662436 | Derick Ian Becios Manabat | Case Manager/Care Coordinator | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-09-07 |
| 1750994893 | Jeremie Bradford | Assistant Behavior Analyst | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-08-28 |
| 1093327116 | Hannah Nicole Schweinfurth | Assistant Behavior Analyst | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-08-19 |
| 1841818911 | Lucy Katende | Assistant Behavior Analyst | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-07-06 |
| 1114544863 | Jose Enrique Sandoval | Behavior Technician | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-06-29 |
| 1770106270 | Joseph N/a Ramirez | Behavior Technician | 5412 Boulder Hwy, Las Vegas, NV 89122-6039 | 2020-05-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902425523 | Dezirae Wilson | Technician | 5180 E Tropicana Ave Apt 46e, Las Vegas, NV 89122 | 2020-04-14 |
| 1407312366 | More Than Words LLC | Speech-Language Pathologist | 3430 Blue Ash Lane, Las Vegas, NV 89122 | 2019-02-15 |
| 1588130751 | Leslie Totress | Case Manager/Care Coordinator | 6368 Foxlyn Ave, Las Vegas, NV 89122 | 2018-10-15 |
| 1780100511 | Easy Living Behavioral Health LLC | Community Based Residential Treatment Facility, Mental Illness | 5069 Sun Valley Dr, Las Vegas, NV 89122 | 2017-08-14 |
| 1508381435 | Louie Taquiqui | Community/Behavioral Health | 3566 Tundra Swan St, Las Vegas, NE 89122 | 2017-08-11 |
| 1972032233 | Marilan Sanchez | Rehabilitation Practitioner | 5210 Emelita St, Las Vegas, NV 89122 | 2017-06-08 |
| 1023479599 | Tia Collins | Social Worker | 5412 Boulder Highway, Las Vegas, NV 89122 | 2016-03-11 |
| 1548673056 | Saba Chatoor | Counselor | 5446 Boulder Hwy Ste G3, Las Vegas, NV 89122 | 2014-06-03 |
| 1811328685 | Derrell Williams | Counselor | 3326 Wasatch Cedars St., Las Vegas, NV 89122 | 2013-12-04 |
| 1225466709 | The Lighthouse LLC | Community/Behavioral Health | 5710 E Tropicana Ave #2212, Las Vegas, NEVADA 89122 | 2013-10-22 |
| Find all providers in zip 89122 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831602325 | Edina Boros | Registered Nurse | 4370 S Grand Canyon Dr Apt 1100, Las Vegas, NV 89147-7114 | 2017-11-07 |
| 1235668518 | Merle Ambray Go | Registered Nurse | 1055 E Flamingo Rd, Apt 224, Las Vegas, NV 89119 | 2017-06-08 |
| 1023544301 | Kellie Marsh | Registered Nurse | 7604 Cruz Bay Ct, Las Vegas, NV 89128-7282 | 2017-05-05 |
| 1730615097 | Erica Zara | Registered Nurse | 2555 Red Springs Dr, Las Vegas, NV 89135-1512 | 2017-05-05 |
| 1972036663 | Ashley Murray | Registered Nurse | 2700 S Las Vegas Blvd #1506, Las Vegas, NV 89109 | 2017-04-10 |
| 1750767695 | Linda Busell | Registered Nurse | 2508 Living Rock St, Las Vegas, NV 89106-1464 | 2015-08-03 |
| 1366831224 | Arthur Kime | Registered Nurse | 3940 Copper Glen St, Las Vegas, NV 89129-7875 | 2015-01-15 |
| 1225335888 | R.u.s.h. Organization | Registered Nurse | 6212 Camino De Rosa, Las Vegas, NV 89108 | 2011-02-17 |
| 1801062567 | Frances Boddie-small | Registered Nurse | 1785 E Sahara Ave Ste 145, Las Vegas, NV 89104-3713 | 2008-05-02 |
| 1033220355 | Marcia Hyatt Evans | Registered Nurse | 912 W Owens Ave, Las Vegas, NV 89106-2516 | 2006-08-31 |
| Find all providers in LAS VEGAS | ||||
Please comment or provide details below to improve the information on GWENDOLYN IVY.
| 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.