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NPI Code Detail

MEDICARE: TRI-STAR PRIMARY CARE LLC

MEDICARE: TRI-STAR PRIMARY CARE LLC
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner
2363LP2300XPrimary Care Nurse Practitioner

General Provider Information

NPI Number : 1346866019
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRI-STAR PRIMARY CARE LLC
Provider Business Mailing Address
First Line : 8778 S MARYLAND PKWY STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-6705
Country : US
Telephone Number : 725-500-4645
Fax Number : 702-442-0947
Provider Business Practice Location Address
First Line : 8778 S MARYLAND PKWY STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-6705
Country : US
Telephone Number : 725-500-4645
Fax Number : 702-442-0947
Authorized Official
Title or Position : OWNER
Name : KATRINA MONTES LEE
Credential : APRN, FNP-C
Telephone Number : 725-500-4645
Provider Enumeration Date : 06/18/2020
Last Update Date : 11/18/2025

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Directions to “TRI-STAR PRIMARY CARE LLC ” Practice Location

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