MEDICARE: KRISTINE JENNIFER NAVAL ANDRES APRN

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	819061	NV

General Provider Information

NPI Number	:	1992360598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINE JENNIFER NAVAL ANDRES APRN

Provider Business Mailing Address
First Line	:	8061 BOSCO BAY AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-6635
Country	:	US
Telephone Number	:	702-606-3731
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 E FLAMINGO RD STE E18
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5244
Country	:	US
Telephone Number	:	702-958-0996
Fax Number	:	702-965-2216

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

Provider Enumeration Date	:	05/08/2019
Last Update Date	:	06/23/2022

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