MEDICARE: JOHANNA SIERRA KIRK

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	163WH0200X	Home Health Registered Nurse	888503	NV

General Provider Information

NPI Number	:	1871469379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHANNA SIERRA KIRK

Provider Business Mailing Address
First Line	:	4246 THUNDER TWICE ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-6069
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4246 THUNDER TWICE ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-6069
Country	:	US
Telephone Number	:	702-592-6594
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2025
Last Update Date	:	10/13/2025

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Directions to “ JOHANNA SIERRA KIRK ” Practice Location

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