MEDICARE: CHRISTINA CERVANTES FND

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	171400000X	Health & Wellness Coach	NV20243177837	NV

General Provider Information

NPI Number	:	1811786122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA CERVANTES FND

Provider Business Mailing Address
First Line	:	10317 FALLS CHURCH AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-1238
Country	:	US
Telephone Number	:	702-595-4780
Fax Number	:

Provider Business Practice Location Address
First Line	:	10317 FALLS CHURCH AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-1238
Country	:	US
Telephone Number	:	702-595-4780
Fax Number	:

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

Provider Enumeration Date	:	05/02/2025
Last Update Date	:	05/06/2025

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