THERESA LEE PEACOCK (NPI# 1083736755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083736755 |
| Entity Type | Individual |
| Full Name | THERESA LEE PEACOCK |
| Credential | NP |
| Practice Address |
3555 W Reno Ave Suite F Las Vegas NV 89118-1609 |
| Practice Telephone | 7022520037 |
| Practice Fax Number | 7022520252 |
| Mailing Telephone | 7022520037 |
| Mailing Fax Number | 7022520252 |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2014-03-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | RN67339 | DC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN001542 | NV | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024167292 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3555 W RENO AVE SUITE F |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89118-1609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790095586 | Desert Medical Rehab LLC | Durable Medical Equipment & Medical Supplies | 3555 W Reno Ave, Suite F, Las Vegas, NV 89118-1609 | 2010-10-14 |
| 1265741029 | Cindy Jo Bushell | Speech-Language Pathologist | 3555 W Reno Ave, Suite F, Las Vegas, NV 89118-1609 | 2010-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720568520 | Kurt Yaross | Behavioral Analyst | 7138 W Post Rd, #208, Las Vegas, NV 89118 | 2018-08-21 |
| 1619457108 | Michelle Herzberg | Behavioral Analyst | 7318 W Post Rd #280, Las Vegas, NV 89118 | 2018-08-15 |
| 1548749385 | Keisha Bere-ruiz | Behavioral Analyst | 7318 W Post Rd #208, Las Vegas, NV 89118 | 2018-08-13 |
| 1295222081 | Aliantcare | Radiologic Technologist | 5490 S Rainbow Blvd, Suite 400 N34835, Las Vegas, NV 89118 | 2018-04-17 |
| 1710406467 | Anoush H. Tacvorian Do LLC | Clinic/Center | 6525 W. Warm Springs Rd, Suite 100, Las Vegas, NV 89118 | 2017-09-13 |
| 1962920470 | Harvard Medtech, LLC | Durable Medical Equipment & Medical Supplies | 6280 S. Valley View Blvd, Suite 412, Las Vegas, NV 89118 | 2017-09-05 |
| 1750827903 | Kerry Cutler | Nurse Practitioner | 6020 South Rainbow Blvd, Suite C, Las Vegas, NV 89118 | 2017-01-12 |
| 1184173015 | Girisgen & Kopolow Od PC | Optometrist | 7090 S Rainbow Blvd, Ste 100, Las Veegas, NV 89118 | 2016-10-04 |
| 1396117859 | Foundation for Positively Kids | Clinic/Center | 3555 E Reno, Ste F, Las Vegas, NV 89118 | 2015-10-23 |
| 1720492663 | Kiet Michael Lam | Chiropractor | 5693 S. Jones Bvld, Ste 116, Las Vegas, NV 89118 | 2014-06-18 |
| Find all providers in zip 89118 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396651 | Alma F Talavera | Nurse Practitioner | 5982 Juniper Falls Ave, Las Vegas, NV 89130-2827 | 2020-11-06 |
| 1154922300 | Reynaly Campos | Nurse Practitioner | 10680 Spruce Bough St, Las Vegas, NV 89183-4631 | 2020-11-04 |
| 1811596463 | Carolina Salaberrios | Nurse Practitioner | 8440 W Lake Mead Blvd Ste 111, Las Vegas, NV 89128-7648 | 2020-10-23 |
| 1851990840 | John Marius Agravio Tolentino | Nurse Practitioner | 3557 Winter Wren St, Las Vegas, NV 89122-3539 | 2020-10-21 |
| 1811596760 | Emmelyn Pineda Rivas | Nurse Practitioner | 7852 Lovely Pine Pl, Las Vegas, NV 89143-4431 | 2020-10-21 |
| 1659979052 | Francis Torres | Nurse Practitioner | 10010 Fort Pike St, Las Vegas, NV 89178-7543 | 2020-10-16 |
| 1144828849 | Julio Arvie Mata Madarazo Jr. | Nurse Practitioner | 6284 Canvasback Ave, Las Vegas, NV 89122-3545 | 2020-10-14 |
| 1104424076 | Khelsey Macaspac | Nurse Practitioner | 6446 Dunns River St, Las Vegas, NV 89166-8064 | 2020-10-13 |
| 1912505199 | Angelica Villahermosa | Nurse Practitioner | 8115 Dancing Bull Ct, Las Vegas, NV 89139-6702 | 2020-10-11 |
| 1467050625 | Ruby Borja | Nurse Practitioner | 7329 Perkins Hill St, Las Vegas, NV 89166-6505 | 2020-10-10 |
| 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.