=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538057484
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KINDORA MEDICAL & WOUNDS PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/26/2025
-----------------------------------------------------
Last Update Date | 12/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9890 S MARYLAND PKWY STE 275
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89183-7169
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-625-6455
-----------------------------------------------------
Fax | 702-648-8932
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9890 S MARYLAND PKWY STE 275
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89183-7169
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-625-6455
-----------------------------------------------------
Fax | 702-648-8932
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | NURSE PRACTITIONER
-----------------------------------------------------
Name | ALECIA GRIMES
-----------------------------------------------------
Credential | DNP, APRN, ACNPC-AG
-----------------------------------------------------
Telephone | 702-625-6455
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------