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

Sanoeun Nan

Individual provider Family Nurse Practitioner · NPI 1356887376

Sanoeun Nan is a Nurse Practitioner in Henderson, Nevada. Qualified in 2016, 10 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in Nevada.

Years since qualifying
10
Licensed in
NV
In the registry since
2017
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Practice location Address checks out

10652 S Eastern Ave
Henderson, NV 89052-4952
Phone: (702) 476-2040
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 002433 (NV)

Record details

NPI number1356887376
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 14, 2017
Last updated in NPPESDecember 1, 2021
Mailing addressPo Box 9101, Coppell, TX 75019-9494

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Henderson