Individual provider Active NPI

Lilian Amaka Etoniru, LPN

  • Licensed Practical Nurse
  • Las Vegas, NV
National Provider Identifier
1932911070
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN16473 Issued in NV
Practice address
250 Pilot Rd
Las Vegas, NV 89119-3542
Phone
(702) 982-3292
NPI assigned
Jan 24, 2025
Last updated
Jan 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN16473 NV Primary

Addresses

Primary practice location

250 Pilot Rd
Las Vegas, NV 89119-3542

Mailing address

250 Pilot Rd
Las Vegas, NV 89119-3542
Phone (702) 982-3292

Other names 1

  • Lilian Amaka Obidike Former name

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
LPN16473NVMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1737676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1932911070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 PILOT RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891193542",
            "telephone_number": "702-982-3292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PILOT RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891193542",
            "telephone_number": "702-982-3292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETONIRU",
        "first_name": "LILIAN",
        "middle_name": "AMAKA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-24",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NV",
            "license": "LPN16473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LILIAN",
            "last_name": "OBIDIKE",
            "middle_name": "AMAKA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jan 24, 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.