Individual provider Active NPI

Liza Sue Ann De Venecia Ligayo Mora, FNP-BC

  • Family Nurse Practitioner
  • Henderson, NV
National Provider Identifier
1619849346
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
842861 Issued in NV
Practice address
2430 W Horizon Ridge Pkwy
Henderson, NV 89052-2729
Phone
(702) 247-9994
Fax
(702) 651-9995
NPI assigned
Sep 22, 2025
Last updated
Sep 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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 842861 NV Primary

Addresses

Primary practice location

2430 W Horizon Ridge Pkwy
Henderson, NV 89052-2729

Mailing address

2430 W Horizon Ridge Pkwy
Henderson, NV 89052-2729
Phone (702) 247-9994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20260105000307 NV Practitioner - Nurse Practitioner 4486140092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2430 W Horizon Ridge Pkwy
Suite 110
Henderson, NV 89052-2729

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
842861NVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Yu Neurology and Electrodiagnostic Center of Nevada LTD CurrentSince Dec 15, 2025 Accepting new patients

Locations

2430 W Horizon Ridge Pkwy
Henderson, NV 89052
Phone (702) 247-9994

653 N Town Center Dr
Ste 104
Las Vegas, NV 89144
Phone (702) 247-9994

1397 S Loop Rd
Pahrump, NV 89048
Phone (775) 727-5500

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": "1758499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1619849346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 W HORIZON RIDGE PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522729",
            "telephone_number": "702-247-9994",
            "fax_number": "702-651-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 W HORIZON RIDGE PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522729",
            "telephone_number": "702-247-9994",
            "fax_number": "702-651-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGAYO MORA",
        "first_name": "LIZA SUE ANN",
        "middle_name": "DE VENECIA",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-22",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "842861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.