Individual provider Active NPI

Amy Louise Haycraft, N.P.

  • Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1194017624
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
890455 Issued in NV
Practice address
9012 Echo Ridge Dr
Las Vegas, NV 89117-5437
Phone
(480) 206-9477
Fax
(949) 991-4208
NPI assigned
May 2, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP3999 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95027546 CA
Nurse Practitioner 363L00000X 608 MN
Nurse Practitioner 363L00000X 890455 NV Primary

Addresses

Primary practice location

9012 Echo Ridge Dr
Las Vegas, NV 89117-5437

Mailing address

9012 Echo Ridge Dr
Las Vegas, NV 89117-5437
Phone (480) 206-9477

Other identifiers 1

IdentifierTypeStateIssuer
4981882917OtherMNPECOS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160203000161 MN Practitioner - Nurse Practitioner 4981882917

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP3999AZMDAdult Health Nurse Practitioner
95027546CAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1304294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1194017624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9012 ECHO RIDGE DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891175437",
            "telephone_number": "480-206-9477",
            "fax_number": "949-991-4208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9012 ECHO RIDGE DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891175437",
            "telephone_number": "480-206-9477",
            "fax_number": "949-991-4208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYCRAFT",
        "first_name": "AMY",
        "middle_name": "LOUISE",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-02",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP3999",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95027546",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "608",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "890455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PECOS",
            "identifier": "4981882917",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.