Healthcare Provider Details

I. General information

NPI: 1649016551
Provider Name (Legal Business Name): KANE MANUEL ARES APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: KANE ARES APRN

II. Dates (important events)

Enumeration Date: 07/01/2024
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1490 W SUNSET RD STE 120
HENDERSON NV
89014-6635
US

IV. Provider business mailing address

9287 HOSNER ST
LAS VEGAS NV
89178-6293
US

V. Phone/Fax

Practice location:
  • Phone: 855-955-5428
  • Fax: 855-389-0835
Mailing address:
  • Phone: 702-885-0787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number879321
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: