Provider Demographics
NPI:1417619966
Name:TEMKENG, YVETTE SIDONIE
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:SIDONIE
Last Name:TEMKENG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 VIA DEL SALVATORE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89011-1704
Mailing Address - Country:US
Mailing Address - Phone:702-334-1526
Mailing Address - Fax:
Practice Address - Street 1:5135 S DURANGO DR STE 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-0160
Practice Address - Country:US
Practice Address - Phone:702-407-9994
Practice Address - Fax:702-407-9998
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV842658363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care