Organization · NPI-2

Incera LLC

Family Medicine · Henderson, NV

NPI number1447794466
StatusActive
Last updated in NPPESNov 17, 2017

Details

NPI
1447794466
Entity type
Organization (NPI-2)
Legal business name
Incera LLC
Organization subpart
No
Enumeration date
Dec 9, 2016
Last updated
Nov 17, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine11608NVYes
2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine11608NV
208M00000X Hospitalist11608NV
208M00000X Hospitalist6826335-1205UT
363LG0600X Nurse Practitioner, GerontologyAPRN001889NV

Practice location

10885 S Eastern Ave
#100
Henderson, NV 89052-5857

Phone 702-419-9977 · Fax 702-921-0222

Mailing address

4030 S Jones Blvd
#32169
Las Vegas, NV 89173-8801

Phone 702-624-5441

Authorized official

Horace Guerra
Owner
7028091171

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