MEDICARE: CHRISTOPHER DAVID KAGAY PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	834958	NV

General Provider Information

NPI Number	:	1174907125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER DAVID KAGAY PMHNP-BC

Provider Business Mailing Address
First Line	:	11021 MOUNT ROYAL AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-4484
Country	:	US
Telephone Number	:	913-282-5436
Fax Number	:

Provider Business Practice Location Address
First Line	:	11021 MOUNT ROYAL AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-4484
Country	:	US
Telephone Number	:	913-282-5436
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2015
Last Update Date	:	04/30/2022

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