Healthcare Provider Details

I. General information

NPI: 1841105905
Provider Name (Legal Business Name): PRISTINEHORMONESANDWEIGHT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 W HUFFAKER LN STE 301
RENO NV
89511-2091
US

IV. Provider business mailing address

180 W HUFFAKER LN STE 301
RENO NV
89511-2091
US

V. Phone/Fax

Practice location:
  • Phone: 775-993-6440
  • Fax: 888-462-3098
Mailing address:
  • Phone: 775-993-6440
  • Fax: 888-462-3098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KRISTINA GONZALEZ
Title or Position: OWNER, PROVIDER
Credential: DNP, FNP-C
Phone: 775-622-2584