Healthcare Provider Details

I. General information

NPI: 1467372540
Provider Name (Legal Business Name): KYRA LUZ PEREZ FNP-C
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6525 N DECATUR BLVD
LAS VEGAS NV
89131-2992
US

IV. Provider business mailing address

11855 PIPPA AVE
LAS VEGAS NV
89138-6328
US

V. Phone/Fax

Practice location:
  • Phone: 702-979-5903
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number871169
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: