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General NPI Number Information
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NPI Number | 1780064212
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Entity Type | Individual
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Provider Name | KARISA KYUEUN SON AGPCNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/29/2015
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Last Update Date | 06/23/2021
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Provider Practice Location Address
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Address Line | 2860 E DESERT INN RD
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City | LAS VEGAS
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State | NV
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Zip | 89121-3605
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Country | US
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Telephone | 702-551-9487
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Fax | 702-924-0634
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Provider Business Mailing Address
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Address Line | 2860 E DESERT INN RD
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City | LAS VEGAS
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State | NV
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Zip | 89121-3605
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Country | US
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Telephone | 702-551-9487
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Fax | 702-924-0634
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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 | APRN002015
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN002015
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License Number State | NV
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