MR. ANDRE WILSON (NPI# 1962907964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962907964 |
| Entity Type | Individual |
| Full Name | MR. ANDRE WILSON |
| Practice Address |
5790 Dana Rogers Dr Las Vegas NV 89110-5518 |
| Practice Telephone | 7026895015 |
| Mailing Telephone | 7026895015 |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2019-12-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747A0650X |
Technician Specialization: Attendant Care Provider |
Nursing Service Related Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538605704 | Andre Wilson | Counselor | 9017 Moray Dr, Shreveport, LA 71129-5127 | 2017-01-12 |
| 1013545805 | Andre Wilson | Registered Nurse | 1045 9th Ave, San Diego, CA 92101-5504 | 2020-03-29 |
| Street Address |
5790 DANA ROGERS DR |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89110-5518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821522848 | Cymbre Young | Community Health Worker | 5790 Dana Rogers Dr, Las Vegas, NV 89110-5518 | 2017-04-17 |
| 1598307100 | Nehru Baskin | Home Health Aide | 5790 Dana Rogers Dr, Las Vegas, NV 89110-5518 | 2019-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932740792 | Egalitarian Nevada LLC | Community/Behavioral Health | 241 North Nellis Boulevard, Suite 103, Las Vegas, NV 89110 | 2019-10-03 |
| 1730698333 | Antoinette Garrett | Rehabilitation Practitioner | 3085 S. Jones Boulevard Ste D., Las Vegas, NV 89110 | 2017-09-26 |
| 1063883486 | Chanfay Michelle Dabney | Adult Companion | 609 Sponseller, Las Vegas, NV 89110 | 2015-10-12 |
| 1689097735 | Lynda C Mccloskey | Registered Nurse | 330 South Valley View, Las Vegas, NV 89110 | 2014-01-27 |
| 1679994487 | Maria Arias De Lujan | Registered Nurse | 570 N Nellis Blvd Suite D1, Las Vegas, NV 89110 | 2013-12-20 |
| 1932520988 | Satoko Brilis | Registered Nurse | 570 N. Nellis Blvd., Suite D-1, Las Vegas, NV 89110 | 2013-12-18 |
| 1245651231 | Loriza Chongtai | Registered Nurse | 570 N.nellis Blvd Suite D1, Las Vegas, NV 89110 | 2013-12-18 |
| 1255752242 | Marites Navarro | Registered Nurse | 570 N. Nellis Blvd Suite D1, Las Vegas, NV 89110 | 2013-12-18 |
| 1770904781 | Karen M Atkins | Registered Nurse | 570 N. Nellis Blvd, Suite D1, Las Vegas, NV 89110 | 2013-12-17 |
| 1780020016 | Emma Jean Watson | Counselor | 3750 East Bonanza Rd Unit 155, Las Vegas, NV 89110 | 2013-05-14 |
| Find all providers in zip 89110 | ||||
| Taxonomy Code | 3747A0650X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Attendant Care Provider |
| An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407455389 | Anisley Martines Rivas | Technician | 4309 W Oakey Blvd, Las Vegas, NV 89102-0529 | 2020-10-21 |
| 1063019651 | Shahad Riyadh F Alani | Technician | 9100 W Flamingo Rd Unit 1004, Las Vegas, NV 89147-6897 | 2020-10-06 |
| 1326655242 | Emanuel Martinez | Technician | 3971 Pebble Creek Ave, Las Vegas, NV 89147-4328 | 2020-09-24 |
| 1730795162 | Samantha Iveth Manzo | Technician | 2770 S Maryland Pkwy Ste A, Las Vegas, NV 89109-1554 | 2020-09-21 |
| 1255944112 | Aaron Willy Lao | Technician | 9646 Deer Park Ave, Las Vegas, NV 89148-4201 | 2020-08-28 |
| 1588275309 | Bernadette Quirante Mundon | Technician | 2624 S Lamb Blvd, Trailer 117, Las Vegas, NV 89121-1836 | 2020-08-14 |
| 1306457486 | Aida Katiuska Garcia-casillas | Technician | 900 Brush St Apt 423, Las Vegas, NV 89107-4063 | 2020-08-12 |
| 1245840909 | Allen Zhang | Technician | 281 Powerbilt Ave, Las Vegas, NV 89148-4411 | 2020-08-06 |
| 1326656778 | Anthony Palma | Technician | 7075 W Gowan Rd Apt 1120, Las Vegas, NV 89129-6291 | 2020-07-21 |
| 1659989242 | Alex Ayala | Technician | 1712 N Jones Blvd, Las Vegas, NV 89108-1622 | 2020-07-20 |
| 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.