Provider Demographics
NPI:1306824057
Name:MENASCHE, KATHLEEN A (CNM)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:A
Last Name:MENASCHE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10625 ARGENTS HILL DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-7353
Mailing Address - Country:US
Mailing Address - Phone:702-860-4232
Mailing Address - Fax:
Practice Address - Street 1:926 W. SUNSET RD. WELL HEAKTH QUALITY CARE
Practice Address - Street 2:# 200
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148
Practice Address - Country:US
Practice Address - Phone:702-255-3547
Practice Address - Fax:702-921-2419
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN00237367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002402092Medicaid
NVCS03171OtherPHARMACY/CDS
NVMM0843208OtherDEA
NVP35407Medicare UPIN
NV002402092Medicaid