=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053263053
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KEEANNA MARIE MERKLE PMHNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/11/2026
-----------------------------------------------------
Last Update Date | 02/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2775 S JONES BLVD STE 101
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89146-5632
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-685-3300
-----------------------------------------------------
Fax | 702-586-3333
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8585 EUREKA HEIGHTS CT
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89178-4876
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-688-9317
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 842254
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------