Provider Demographics
NPI:1053148627
Name:YANOS, CASEY OGURA (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CASEY
Middle Name:OGURA
Last Name:YANOS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:VENTURA
Other - Last Name:OGURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11250 FORMOSA SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-5127
Mailing Address - Country:US
Mailing Address - Phone:808-375-7353
Mailing Address - Fax:
Practice Address - Street 1:4212 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1625
Practice Address - Country:US
Practice Address - Phone:702-312-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-18
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV817590363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily