Individual provider Active NPI

Nicolette A Eberline, DNP-FNP

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1568061398
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
66011 Issued in ID
Practice address
7965 W Sahara Ave
Las Vegas, NV 89117-1991
Phone
(725) 222-8260
Fax
(855) 741-5953
NPI assigned
Oct 22, 2020
Last updated
Dec 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 66011 ID Primary

Addresses

Primary practice location

7965 W Sahara Ave
Las Vegas, NV 89117-1991

Mailing address

7965 W Sahara Ave
Las Vegas, NV 89117-1991
Phone (725) 222-8260

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

State licenses

LicenseStateTypeSpecialty
66011IDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness & Hormones Avenue Family CurrentSince Dec 14, 2025 Accepting new patients

Locations

7965 W Sahara Ave
Las Vegas, NV 89117
Phone (725) 222-8260

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1568061398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7965 W SAHARA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891171991",
            "telephone_number": "725-222-8260",
            "fax_number": "855-741-5953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7965 W SAHARA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891171991",
            "telephone_number": "725-222-8260",
            "fax_number": "855-741-5953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERLINE",
        "first_name": "NICOLETTE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DNP-FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-22",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "66011",
            "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 Dec 11, 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.