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NPI Code Detail

MEDICARE: DAMARIS KIPTOO APRN

MEDICARE: DAMARIS KIPTOO APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramNV
2363L00000XNurse Practitioner887859NV

General Provider Information

NPI Number : 1104667591
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAMARIS KIPTOO APRN
Provider Business Mailing Address
First Line : 400 N STEPHANIE ST STE 300
Second Line :
City : HENDERSON
State : NV
Zip : 89014-6692
Country : US
Telephone Number : 702-952-3350
Fax Number : 702-952-3364
Provider Business Practice Location Address
First Line : 7445 PEAK DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-9011
Country : US
Telephone Number : 702-952-2140
Fax Number : 702-952-2147
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2024
Last Update Date : 08/12/2024

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Directions to “ DAMARIS KIPTOO APRN” Practice Location

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