MEDICARE: HAVEN WOMEN'S CARE LLC

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
1	176B00000X	Midwife
2	363LP2300X	Primary Care Nurse Practitioner

General Provider Information

NPI Number	:	1366383481
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAVEN WOMEN'S CARE LLC

Provider Business Mailing Address
First Line	:	PO BOX 401477
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89140-1477
Country	:	US
Telephone Number	:	702-830-5325
Fax Number	:	702-830-4385

Provider Business Practice Location Address
First Line	:	171 N GIBSON RD STE 130
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89014-6787
Country	:	US
Telephone Number	:	702-830-5325
Fax Number	:	702-830-4385

Authorized Official
Title or Position	:	CEO
Name	:	KANDY MORRIS
Credential	:
Telephone Number	:	702-830-5325

Provider Enumeration Date	:	04/02/2026
Last Update Date	:	04/02/2026

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