Healthcare Provider Details

I. General information

NPI: 1760377063
Provider Name (Legal Business Name): CHRISTINE BUENAFLOR FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5701 W CHARLESTON BLVD
LAS VEGAS NV
89146-1217
US

IV. Provider business mailing address

5454 JACOBS FIELD ST
LAS VEGAS NV
89148-4616
US

V. Phone/Fax

Practice location:
  • Phone: 702-818-2444
  • Fax:
Mailing address:
  • Phone: 702-265-6003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number850009
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number850009
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: