Individual ProviderKayoko DinehartNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address6070 S Fort Apache Rd Ste 100, Las Vegas, NV 89148-5615(702) 803-5534PECOS EnrollmentBased on the most recent information from CMS, provider Kayoko Dinehart is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1427328657Provider TypeIndividualFull NameDinehart, KayokoCredentialNURSE PRACTITIONERGenderFemaleSole ProprietorNoEnumeration Date1/4/2012Last Updated4/24/2023Contact InformationPractice LocationPractice Address6070 S Fort Apache Rd Ste 100, Las Vegas, NV 89148-5615Phone(702) 803-5534Fax(888) 977-1206Mailing LocationMailing Address21 W Horizon Ridge Pkwy, Henderson, NV 89012-5307PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense815188NevadaCode163W00000XDescriptionRegistered NurseNursing Service ProvidersLicense530884CaliforniaCode363LF0000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense18617South CarolinaCode363LF0000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense18035California