Individual provider Active NPI

Karissa Nicole Proctor, RN

  • Registered Nurse
  • Las Vegas, NV
National Provider Identifier
1114732195
Registry record updated Feb 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
885879 Issued in NV
Practice address
3161 E Warm Springs Rd Ste 400
Las Vegas, NV 89120-3144
Phone
(702) 463-1260
NPI assigned
Feb 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 885879 NV Primary

Addresses

Primary practice location

3161 E Warm Springs Rd Ste 400
Las Vegas, NV 89120-3144

Mailing address

3161 E Warm Springs Rd Ste 400
Las Vegas, NV 89120-3144
Phone (702) 463-1260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
885879NVMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1738972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738972800000",
    "number": "1114732195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3161 E WARM SPRINGS RD STE 400",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891203144",
            "telephone_number": "702-463-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3161 E WARM SPRINGS RD STE 400",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891203144",
            "telephone_number": "702-463-1260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "KARISSA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-08",
        "last_updated": "2025-02-08",
        "certification_date": "2025-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "885879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.