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NPI Code Detail

MEDICARE: KRISTINE MUKUNA NP-C

MEDICARE: KRISTINE MUKUNA NP-C
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
1363L00000XNurse PractitionerAPRN832256NV

General Provider Information

NPI Number : 1346852183
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINE MUKUNA NP-C
Provider Business Mailing Address
First Line : 3758 LAS VEGAS BLVD S
Second Line :
City : LAS VEGAS
State : NV
Zip : 89109-4132
Country : US
Telephone Number : 401-585-8069
Fax Number :
Provider Business Practice Location Address
First Line : 3758 LAS VEGAS BLVD S
Second Line :
City : LAS VEGAS
State : NV
Zip : 89109-4132
Country : US
Telephone Number : 401-585-8069
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2020
Last Update Date : 10/27/2021

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Directions to “ KRISTINE MUKUNA NP-C” Practice Location

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