MEDICARE: KRISTY TRAN PHARM.D

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	183500000X	Pharmacist	16201	NV

General Provider Information

NPI Number	:	1780049163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTY TRAN PHARM.D

Provider Business Mailing Address
First Line	:	2120 CACTUS DESERT CT
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-3172
Country	:	US
Telephone Number	:	702-639-9002
Fax Number	:	702-639-1632

Provider Business Practice Location Address
First Line	:	5940 LOSEE RD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-6591
Country	:	US
Telephone Number	:	702-639-9002
Fax Number	:	702-639-1632

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

Provider Enumeration Date	:	12/29/2015
Last Update Date	:	12/29/2015

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