Healthcare Provider Details

I. General information

NPI: 1043020514
Provider Name (Legal Business Name): RICKEDRA VANECIA MARTIN-ADAMS APRN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2025
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8880 W SUNSET RD STE 275
LAS VEGAS NV
89148-5333
US

IV. Provider business mailing address

8880 W SUNSET RD STE 275
LAS VEGAS NV
89148-5333
US

V. Phone/Fax

Practice location:
  • Phone: 702-780-4766
  • Fax: 888-322-5654
Mailing address:
  • Phone: 702-780-4766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number885580
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: