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General NPI Number Information
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NPI Number | 1114773447
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Entity Type | Individual
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Provider Name | KESHONA ISAACKSZ NP
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Gender | Female
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Dates
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Enumeration Date | 04/26/2024
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Last Update Date | 04/26/2024
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Provider Practice Location Address
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Address Line | 3601 W SAHARA AVE STE 211
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City | LAS VEGAS
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State | NV
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Zip | 89102-5821
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Country | US
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Telephone | 725-255-7865
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Fax |
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Provider Business Mailing Address
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Address Line | 7181 N HUALAPAI WAY STE 130748
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City | LAS VEGAS
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State | NV
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Zip | 89166-1115
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Country | US
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Telephone | 702-308-8940
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 816179
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License Number State | NV
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