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NPI Code Detail

MEDICARE: MR. EMMANUEL S EKWERE CRNP

MEDICARE: MR. EMMANUEL S EKWERE CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner830196NV
2363LF0000XFamily Nurse PractitionerSP013565PA

General Provider Information

NPI Number : 1013339886
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EMMANUEL S EKWERE CRNP
Provider Business Mailing Address
First Line : 3758 LAS VEGAS BLVD S
Second Line :
City : LAS VEGAS
State : NV
Zip : 89109-4132
Country : US
Telephone Number : 302-252-1519
Fax Number :
Provider Business Practice Location Address
First Line : 3550 W SAHARA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-5867
Country : US
Telephone Number : 702-873-7171
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2014
Last Update Date : 01/09/2026

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