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General NPI Number Information
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NPI Number | 1972560175
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Entity Type | Individual
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Provider Name | DANIEL KREUN P.A.C.
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Gender | Male
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Dates
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Enumeration Date | 05/01/2006
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Last Update Date | 08/12/2021
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Provider Practice Location Address
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Address Line | 861 CORONADO CENTER DR SUITE 200
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City | HENDERSON
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State | NV
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Zip | 89052-3992
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Country | US
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Telephone | 702-896-0940
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Fax | 702-896-6173
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Provider Business Mailing Address
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Address Line | PO BOX 95306
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City | LAS VEGAS
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State | NV
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Zip | 89193-5306
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Country | US
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Telephone | 702-948-8897
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Fax | 702-549-3178
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA668
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License Number State | NV
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