MEDICARE: CHRISTIAN IWOBI FNP

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
1	363LF0000X	Family Nurse Practitioner	18485	CA

General Provider Information

NPI Number	:	1295066801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIAN IWOBI FNP

Provider Business Mailing Address
First Line	:	9105 W FLAMINGO RD APT 1011
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-6431
Country	:	US
Telephone Number	:	469-536-5899
Fax Number	:	702-760-5818

Provider Business Practice Location Address
First Line	:	6415 S FORT APACHE RD STE 185
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-6746
Country	:	US
Telephone Number	:	702-530-2266
Fax Number	:	702-760-5818

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2010
Last Update Date	:	12/12/2024

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