Kimberly Statum, REGISTED NURSE

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

818769 Issued in NV

Practice address

860 S Rancho Dr Ste 10
Las Vegas, NV 89106-3828

Phone

(702) 268-8555

Fax

(702) 272-2541

NPI assigned

Sep 22, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1695340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1548049232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 S RANCHO DR STE 10",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891063828",
            "telephone_number": "702-268-8555",
            "fax_number": "702-272-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 S RANCHO DR STE 10",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891063828",
            "telephone_number": "702-268-8555",
            "fax_number": "702-272-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATUM",
        "first_name": "KIMBERLY",
        "name_prefix": "Ms.",
        "credential": "REGISTED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-22",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "818769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NEVADA BOARD OF NURSING",
            "identifier": "818769",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Inez NMN Staten
• Stateserv Homecare LLC
• Lormeshia Kay Staton
• Michael Staton, MD
• Tiffany Nicole Stattman
• Stephanie Staub, MS ED
• Sallye Louise Stauber, DNP, FNP-C
• Becky Staudacher, MS, BCBA
• Carol Staudt
• Debra J Stauffer, MNT

• Registered Nurse in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Registered Nurse in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; 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.