Healthcare Provider Details

I. General information

NPI: 1760799274
Provider Name (Legal Business Name): CHRISTINE MAY CENDANA APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2010
Last Update Date: 04/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 ALMOND TREE LN SUITE 306
LAS VEGAS NV
89104-3233
US

IV. Provider business mailing address

1140 ALMOND TREE LN SUITE 306
LAS VEGAS NV
89104-3233
US

V. Phone/Fax

Practice location:
  • Phone: 702-657-3873
  • Fax: 702-636-0787
Mailing address:
  • Phone: 702-657-3873
  • Fax: 702-636-0787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License NumberAPN001214
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN001214
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: