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General NPI Number Information
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NPI Number | 1740048305
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Entity Type | Organization
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Legal Business Name | DESERT SNOW LLC
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Dates
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Enumeration Date | 03/08/2024
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 9490 VETERANS CT
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City | LAS VEGAS
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State | NV
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Zip | 89148-4631
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Country | US
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Telephone | 646-593-3564
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Fax |
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Provider Business Mailing Address
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Address Line | 9490 VETERANS CT
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City | LAS VEGAS
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State | NV
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Zip | 89148-4631
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Country | US
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Telephone | 702-867-0800
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Fax | 866-384-4453
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Authorized Official
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Title or Position | NP-C, WCS-S, EDS-C/OWNER
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Name | MRS. CHARISSE L KOKSENG
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Credential | NP-C
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Telephone | 702-867-0800
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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 |
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License Number State |
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