AMANDA LYNNE FAGAN (NPI# 1245617802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245617802 |
| Entity Type | Individual |
| Full Name | AMANDA LYNNE FAGAN |
| Other Name | AMANDA LYNNE STUCK |
| Credential | D.O |
| Practice Address |
2845 Siena Heights Dr Henderson NV 89052-4153 |
| Mailing Address |
620 Shadow Lane Las Vegas NV 89106-4194 |
| Practice Telephone | 7024924896 |
| Practice Fax Number | 7024929514 |
| Mailing Telephone | 7023888436 |
| Mailing Fax Number | 7023888431 |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2018-10-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | DO2319 | NV | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | SL1068 | NV | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104313899 | Amanda Fagan | Counselor | 301 Fort Ln, Portsmouth, VA 23704-2221 | 2018-04-18 |
| Street Address |
2845 SIENA HEIGHTS DR |
| City | HENDERSON |
| State | NV |
| Zip Code | 89052-4153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558350827 | Chang-hoon Ahn | Family Medicine | 2845 Siena Heights Dr, Henderson, NV 89052-4153 | 2005-10-19 |
| 1386201341 | William Song | Nurse Practitioner | 2845 Siena Heights Dr, Henderson, NV 89052-4153 | 2019-05-24 |
| 1831666338 | Kayanna M. Gilbert | Physician Assistant | 2845 Siena Heights Dr, Henderson, NV 89052-4153 | 2018-11-01 |
| 1356833222 | Roshni Panchal Graydus | Nurse Practitioner | 2845 Siena Heights Dr, Henderson, NV 89052-4153 | 2018-06-05 |
| 1972006476 | Julienne Go | Nurse Practitioner | 2845 Siena Heights Dr, Henderson, NV 89052 | 2018-03-12 |
| 1083157705 | Southwest Medical Associates | Health Maintenance Organization | 2845 Siena Heights Dr, Henderson, NV 89052-4153 | 2016-11-29 |
| 1427405869 | Andrew Stanton | Family Medicine | 2845 Siena Heights Dr, Henderson, NV 89052 | 2016-05-16 |
| 1710340179 | Jing Qian Zhang | Family Medicine | 2845 Siena Heights Dr, Henderson, NV 89052-4153 | 2016-04-03 |
| 1306225750 | Arshia Rassi | Obstetrics & Gynecology | 2845 Siena Heights Dr, Henderson, NV 89052 | 2015-05-19 |
| 1861899809 | Wendi Tsukada | Physician Assistant | 2845 Siena Heights Dr, Henderson, NV 89052-4153 | 2014-11-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740889112 | Nathan Michael Nasternak | Physical Therapist | 750 Coronado Center Drive, Suite 140, 2212, Henderson, NV 89052 | 2020-10-18 |
| 1558987180 | Braxton Chad Storm | Counselor | 2990 W. Sundridge Heights Pkwy, Suite #140, Henderson, NV 89052 | 2020-06-19 |
| 1558996546 | The Eye Doctor At St. Rose LLC | Eyewear Supplier (Equipment, not the service) | 2645 St. Rose Parkway, Suite C-110, Henderson, NV 89052 | 2020-03-10 |
| 1770138521 | Quinn Dentists of St. Rose, PC | Dentist | 3519 St Rose Parkway, Ste 110, Henderson, NV 89052 | 2019-08-08 |
| 1346802568 | Rickie Kwong Chin Jr. | Optometrist | 695 S. Green Valley Pkwy, Henderson, NV 89052 | 2019-07-08 |
| 1134695646 | Nu Smiles, LLC | Clinic/Center | 2810 W. Horizon Ridge Parkway, Suite #110, Henderson, NV 89052 | 2018-10-23 |
| 1003393497 | Katherine Lee Villarreal | Physical Therapist | 2930 W Horizon Pkwy, Suite 205, Henderson, NV 89052 | 2018-07-27 |
| 1790281889 | Vicki Lorraine Schmidt | Nurse Practitioner | 2900 W. Horizon Ridge Pkwy, Suite 101, Henderson, NV 89052 | 2018-04-05 |
| 1326566969 | Shelby Schiller | Social Worker | 3051 W Horizon Ridge Pkwy Ste 104a, Henderson, NV 89052 | 2017-09-04 |
| 1639696826 | Pca Ventures, LLC | Technician | 2656 Soda Butte Court, Henderson, NV 89052 | 2017-08-28 |
| Find all providers in zip 89052 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740807619 | Sherrin Soliman | Family Medicine | 761 Crest Valley Pl, Henderson, NV 89011-2663 | 2020-06-26 |
| 1932724143 | Qv Now Pllc | Family Medicine | 1600 Us Highway 79 S Ste B, Henderson, TX 75654-4508 | 2020-06-12 |
| 1154944544 | Partners In Primary Care Nv PC | Family Medicine | 390 W Lake Mead Pkwy, Henderson, NV 89015-7417 | 2020-05-20 |
| 1689134116 | Transforming Arts Inc | Family Medicine | 2900 N Green Valley Pkwy Ste 114, Henderson, NV 89014-0408 | 2019-03-21 |
| 1609359165 | Kenisha Voncille Thomas | Family Medicine | 1520 W Sunset Rd Ste 130, Henderson, NV 89014 | 2018-09-11 |
| 1336636521 | Bob Dillon Enterprises Ltd | Family Medicine | 90 S Stephanie St Ste 110, Henderson, NV 89012-5574 | 2018-04-13 |
| 1013425255 | Bikramjit Singh Nanar | Family Medicine | 1382 Opal Valley St, Henderson, NV 89052-3146 | 2018-01-22 |
| 1265965263 | La Boss LLC | Family Medicine | 2404 Chateau Napoleon Dr, Henderson, NV 89044-0377 | 2017-04-06 |
| 1679922959 | Sonia Garcia-jayne | Family Medicine | 2645 W Horizon Ridge Pkwy Ste 120, Henderson, NV 89052 | 2016-06-08 |
| 1043668015 | Michelle I-hung Lin | Family Medicine | 2865 Siena Heights Dr Ste 140, Henderson, NV 89052-4168 | 2016-05-31 |
| Find all providers in HENDERSON | ||||
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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.