MEDICARE: DR. NIKESHA MOBLEY DNP, APRN-CNP

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	363LA2100X	Acute Care Nurse Practitioner	812428	NV

General Provider Information

NPI Number	:	1902384472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NIKESHA MOBLEY DNP, APRN-CNP

Provider Business Mailing Address
First Line	:	2653 VIA MONET
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89044-1730
Country	:	US
Telephone Number	:	773-814-2440
Fax Number	:

Provider Business Practice Location Address
First Line	:	1070 W HORIZON RIDGE PKWY STE 111
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89012-6019
Country	:	US
Telephone Number	:	702-336-0843
Fax Number	:

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

Provider Enumeration Date	:	08/06/2018
Last Update Date	:	05/22/2020

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