MEDICARE: MEKENI, 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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1235068891
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEKENI, LLC

Provider Business Mailing Address
First Line	:	6282 CYPRESS SPRINGS CIR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5198
Country	:	US
Telephone Number	:	702-688-2507
Fax Number	:	725-238-1683

Provider Business Practice Location Address
First Line	:	732 S 6TH ST STE 8080
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-6948
Country	:	US
Telephone Number	:	702-688-2507
Fax Number	:	725-238-1683

Authorized Official
Title or Position	:	OWNER
Name	:	GINA BALGOYEN
Credential	:	APRN
Telephone Number	:	702-688-2507

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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