MEDICARE: CAROL ANN KOBASHIGAWA 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	APN000601	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326075979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL ANN KOBASHIGAWA FNP

Provider Business Mailing Address
First Line	:	8902 W KATIE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-6571
Country	:	US
Telephone Number	:	702-838-8926
Fax Number	:	705-838-8926

Provider Business Practice Location Address
First Line	:	3220 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1932
Country	:	US
Telephone Number	:	702-878-7776
Fax Number	:	702-878-7078

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

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	08/24/2007

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