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NPI Code Detail

MEDICARE: KRISTIN ANNE LAXALT M.D.

MEDICARE: KRISTIN ANNE LAXALT M.D.
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
1207Q00000XFamily Medicine Physician5951NV

General Provider Information

NPI Number : 1346442688
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN ANNE LAXALT M.D.
Provider Business Mailing Address
First Line : 1260 NEVADA PACIFIC BLVD
Second Line :
City : FERNLEY
State : NV
Zip : 89408-9871
Country : US
Telephone Number : 775-575-7171
Fax Number : 775-575-7227
Provider Business Practice Location Address
First Line : 1260 NEVADA PACIFIC BLVD
Second Line :
City : FERNLEY
State : NV
Zip : 89408-9871
Country : US
Telephone Number : 775-575-7171
Fax Number : 775-575-7227
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2007
Last Update Date : 03/24/2021

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Directions to “ KRISTIN ANNE LAXALT M.D.” Practice Location

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