Healthcare Provider Details

I. General information

NPI: 1093381113
Provider Name (Legal Business Name): CHRISTINA ANN CISNEROS APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2021
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6970 S CIMARRON RD # 230
LAS VEGAS NV
89113-2135
US

IV. Provider business mailing address

8906 SPANISH RIDGE AVE STE 202
LAS VEGAS NV
89148-1319
US

V. Phone/Fax

Practice location:
  • Phone: 702-871-0303
  • Fax: 702-562-0054
Mailing address:
  • Phone: 702-330-3102
  • Fax: 702-912-4994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number841808
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: