Provider Demographics
NPI:1649016551
Name:ARES, KANE MANUEL (APRN)
Entity type:Individual
Prefix:
First Name:KANE MANUEL
Middle Name:
Last Name:ARES
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:KANE
Other - Middle Name:
Other - Last Name:ARES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:9287 HOSNER ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-6293
Mailing Address - Country:US
Mailing Address - Phone:702-885-0787
Mailing Address - Fax:
Practice Address - Street 1:1490 W SUNSET RD STE 120
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-6635
Practice Address - Country:US
Practice Address - Phone:855-955-5428
Practice Address - Fax:855-389-0835
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV879321363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily