Healthcare Provider Details

I. General information

NPI: 1154213551
Provider Name (Legal Business Name): JUSTINE RYKHUS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2025
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7345 S DURANGO DR STE 111
LAS VEGAS NV
89113-3608
US

IV. Provider business mailing address

4418 SOLITUDE FALLS AVE
NORTH LAS VEGAS NV
89084-4731
US

V. Phone/Fax

Practice location:
  • Phone: 702-463-1400
  • Fax:
Mailing address:
  • Phone: 619-550-8866
  • Fax: 619-550-8866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number833814
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: