Provider Demographics
NPI:1083076269
Name:KLEINMAN, KRISTOPHER KEVIN (RN, NP)
Entity Type:Individual
Prefix:MR
First Name:KRISTOPHER
Middle Name:KEVIN
Last Name:KLEINMAN
Suffix:
Gender:M
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11752 VIA ESPERANZA AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89138-6025
Mailing Address - Country:US
Mailing Address - Phone:801-792-8012
Mailing Address - Fax:
Practice Address - Street 1:5550 PAINTED MIRAGE RD STE 217
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149
Practice Address - Country:US
Practice Address - Phone:702-410-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-25
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN82632163W00000X
NV810017363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV810017OtherNEVADA NURSING BOARD