Healthcare Provider Details

I. General information

NPI: 1548731003
Provider Name (Legal Business Name): KARIN DINDA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2018
Last Update Date: 12/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 S DECATUR BLVD
LAS VEGAS NV
89107-2936
US

IV. Provider business mailing address

280 S DECATUR BLVD
LAS VEGAS NV
89107-2936
US

V. Phone/Fax

Practice location:
  • Phone: 702-759-0769
  • Fax: 702-759-1431
Mailing address:
  • Phone: 702-759-0769
  • Fax: 702-759-1431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN85350
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: