Healthcare Provider Details

I. General information

NPI: 1427246578
Provider Name (Legal Business Name): CHRISTINE T ESTEPA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2007
Last Update Date: 07/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 E LAKE MEAD PKWY STE 307
HENDERSON NV
89015-6444
US

IV. Provider business mailing address

98 E LAKE MEAD PKWY STE 307
HENDERSON NV
89015-6444
US

V. Phone/Fax

Practice location:
  • Phone: 702-483-2969
  • Fax: 702-761-2339
Mailing address:
  • Phone: 702-483-2969
  • Fax: 702-761-2339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPN000961
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAPRN000961
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberAPRN000961
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: