ANDREA IRENE PETTY (NPI# 1194387886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194387886 |
| Entity Type | Individual |
| Full Name | ANDREA IRENE PETTY |
| Credential | PMHNP |
| Practice Address |
2021 S Jones Blvd Las Vegas NV 89146-3137 |
| Mailing Address |
2702 Black Locust Ct Chula Vista CA 91915-1711 |
| Practice Telephone | 7022020099 |
| Mailing Telephone | 6199930291 |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2020-09-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
95015570 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
811308 | NV | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3853 Rosecrans St, San Diego, CA 921103115 | 6196150439 | |
| 1126 N 2nd St, El Cajon, CA 920215008 | 6194470910 |
| Street Address |
2021 S JONES BLVD |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89146-3137 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134139884 | Victor Bruce | Internal Medicine | 2021 S Jones Blvd, Las Vegas, NV 89146 | 2006-08-08 |
| 1346849908 | Lawren Meshell Perry | Registered Nurse | 2021 S Jones Blvd, Las Vegas, NV 89146-3137 | 2020-10-23 |
| 1003395096 | Brightstar Urgent Care | Clinic/Center | 2021 S Jones Blvd, Las Vegas, NV 89146-3137 | 2018-08-09 |
| 1750887113 | Kelly Figueroa | Behavior Technician | 2021 S Jones Blvd, Las Vegas, NV 89146-3137 | 2018-04-04 |
| 1184149254 | Inez Watson | Counselor | 2021 S Jones Blvd, Las Vegas, NV 89146-3137 | 2017-08-09 |
| 1558894402 | Kristina May Dunn | Counselor | 2021 S Jones Blvd, Las Vegas, NV 89146-3137 | 2017-04-07 |
| 1114465192 | Matthew Okeke, M.d. Ltd | Counselor | 2021 S Jones Blvd, Las Vegas, NV 89146-3137 | 2017-02-09 |
| 1821540725 | Erinn Michelae Robles | Behavior Technician | 2021 S Jones Blvd, Las Vegas, NV 89146-3137 | 2016-10-26 |
| 1962952952 | Grand Desert Psychiatric Svc | Counselor | 2021 S Jones Blvd, Las Vegas, NV 89146-3137 | 2016-10-13 |
| 1770930653 | Patricia Moreno Chapelin | Behavioral Analyst | 2021 S Jones Blvd, Las Vegas, NV 89146-3137 | 2016-05-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821607193 | State of Nevada | Community/Behavioral Health | 6171 W Charleston Blvd Bldg 15, Las Vegas, NV 89146 | 2020-07-23 |
| 1730726597 | Jenna Leigh White | Occupational Therapist | 2012 S Jones Blvd., Las Vegas, NV 89146 | 2019-11-28 |
| 1649828898 | Rocio Ferat | Chore Provider | 5000 W. Oakey Suite E.i, Las Vegas, NV 89146 | 2019-08-30 |
| 1912554007 | Juan Zamora | Chore Provider | 5000 W. Oakey Bld Suite E-1, Las Vegas, NV 89146 | 2019-08-22 |
| 1407402530 | Elia Rocio Vargas-sifuentes | Chore Provider | 5000 W Oakey, Suite E.i, Las Vegas, NV 89146 | 2019-08-14 |
| 1740834050 | Zi Wang | Physician Assistant | 5300 Spring Mountain Rd Ste 112, Las Vegas, NV 89146 | 2019-07-25 |
| 1871145565 | Virginia Lopez Lopez | Chore Provider | 5000 W. Oakey Blvd. Suite E-1, Las Vegas, NV 89146 | 2019-07-12 |
| 1962054726 | Nona Sixta Q Baldonado | Technician | 5450 W Sahara Ave Ste 250a, Las Vegas, NV 89146 | 2019-07-11 |
| 1326600701 | Thelma Moreno Cerros | Chore Provider | 5000 W. Oakey Blvd Suite E-1, Las Vegas, NV 89146 | 2019-07-05 |
| 1992367866 | Carolina Perez | Chore Provider | 5000 W Oakey Blvd Suite E-1, Las Vegas, NV 89146 | 2019-07-01 |
| Find all providers in zip 89146 | ||||
| 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 |
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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.