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NPI Code Detail

MEDICARE: KRISTINE PERALTA APRN

MEDICARE: KRISTINE PERALTA APRN
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
1363LF0000XFamily Nurse Practitioner891482NV
2363L00000XNurse Practitioner891482NV

General Provider Information

NPI Number : 1275423055
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINE PERALTA APRN
Provider Business Mailing Address
First Line : PO BOX 749495
Second Line :
City : ATLANTA
State : GA
Zip : 30374-9495
Country : US
Telephone Number : 855-963-2100
Fax Number : 813-321-1296
Provider Business Practice Location Address
First Line : 6827 W TROPICANA AVE STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-4920
Country : US
Telephone Number : 702-508-9128
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2025
Last Update Date : 07/17/2025

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Directions to “ KRISTINE PERALTA APRN” Practice Location

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