Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kelli Nissen

Individual provider Gerontology Nurse Practitioner · NPI 1952093692

Kelli Nissen is a Nurse Practitioner in Las Vegas, Nevada. Qualified in 2023, 3 years ago. Practices with Haraway Medical Group PLLC, a 5-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Nevada.

Years since qualifying
3
Licensed in
NV
In the registry since
2023
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Practice location Address checks out

7730 W Cheyenne Ave Ste 107
Las Vegas, NV 89129-8412
Phone: (725) 333-9218
Fax: (833) 485-4980
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 867835 (NV)

Record details

NPI number1952093692
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 22, 2023
Last updated in NPPESMarch 15, 2026
Certification dateMarch 15, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Haraway Medical Group Pllc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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