Individual provider Active NPI

Jeniffer Creque, APRN

  • Gerontology Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1902377229
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
815834 Issued in NV
Practice address
6040 S Fort Apache Rd Ste 100
Las Vegas, NV 89148-5613
Phone
(702) 476-4900
Fax
(702) 476-4949
NPI assigned
Dec 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 815834 NV Primary

Addresses

Primary practice location

6040 S Fort Apache Rd Ste 100
Las Vegas, NV 89148-5613

Mailing address

6040 S Fort Apache Rd Ste 100
Las Vegas, NV 89148-5613
Phone (702) 476-4900

Other practice location 1

3001 Saint Rose Pkwy
Henderson, NV 89052-3839
Phone (702) 616-5615

Other practice location 2

8280 W Warm Springs Rd
Las Vegas, NV 89113-3612
Phone (702) 492-8614

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
I20190410002542 NV Practitioner - Nurse Practitioner 9234470758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eid Nevada Critical Care PLLCGroup PAC ID 9537357793, 62 clinicians

Practice addresses (Care Compare)

6040 S Fort Apache Rd
Suite 100
Las Vegas, NV 89148-5613
Phone (702) 476-4900

Hospital & facility affiliations

  • Sunrise Hospital and Medical Center Hospital, Las Vegas, NV, CCN 290003
  • Havasu Regional Medical Center Hospital, Lake Havasu City, AZ, CCN 030069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
815834NVMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eid Nevada Critical Care PLLC CurrentSince Mar 1, 2019 Accepting new patients

Locations

1801 W Olympic Blvd
#1270
Pasadena, CA 91199

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

6040 S Fort Apache Rd
Ste 100
Las Vegas, NV 89148
Phone (702) 475-4007

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1544745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1902377229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6040 S FORT APACHE RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485613",
            "telephone_number": "702-476-4900",
            "fax_number": "702-476-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 S FORT APACHE RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485613",
            "telephone_number": "702-476-4900",
            "fax_number": "702-476-4949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3001 Saint Rose Pkwy",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890523839",
            "country_code": "US",
            "telephone_number": "702-616-5615",
            "fax_number": "702-616-5120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8280 W Warm Springs Rd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891133612",
            "country_code": "US",
            "telephone_number": "702-492-8614",
            "fax_number": "702-492-8163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CREQUE",
        "first_name": "JENIFFER",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-14",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NV",
            "license": "815834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.