Unknown Individual – Licensed Practical Nurse, NPI 1063969855

Unknown Individual is a healthcare provider. based in Gardnerville, Nevada. specializing in Licensed Practical Nurse. They hold a License No. LPN03974 (NV). The NPI Number for Unknown Individual is 1063969855

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1063969855
Phone
(775) 265-8621
Address
1559 WATASHEAMU RD
Deactivation Date
22 November 2023
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 1559 WATASHEAMU RD

    GARDNERVILLE, NV 894607455

    Phone: (775) 265-8621

    Fax: (775) 265-6071

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 89460)

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Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1063969855 if you need a stable reference for Unknown Individual.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Licensed Practical Nurse. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Gardnerville, Nevada for Unknown Individual; download NPPES for the complete set.
What if Gardnerville, Nevada seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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