Healthcare Provider Details

I. General information

NPI: 1871383778
Provider Name (Legal Business Name): NATIWA KINARES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 PILOT RD STE 250
LAS VEGAS NV
89119-3514
US

IV. Provider business mailing address

2884 REEF BAY LN
LAS VEGAS NV
89128-7271
US

V. Phone/Fax

Practice location:
  • Phone: 725-239-8691
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number845564
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: