Healthcare Provider Details

I. General information

NPI: 1508554163
Provider Name (Legal Business Name): KRISTINA FOTI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2023
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3041 W HORIZON RIDGE PKWY STE 165
HENDERSON NV
89052-5061
US

IV. Provider business mailing address

2880 BICENTENNIAL PKWY STE 100 PMB 200
HENDERSON NV
89044-4484
US

V. Phone/Fax

Practice location:
  • Phone: 702-834-7300
  • Fax: 702-902-2400
Mailing address:
  • Phone: 702-834-7300
  • Fax: 702-902-2400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number865921
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: