Provider Demographics
NPI:1346786498
Name:DY-PATACSIL, KAHRENANNE ALEGRE (APRN, NP-C)
Entity Type:Individual
Prefix:
First Name:KAHRENANNE
Middle Name:ALEGRE
Last Name:DY-PATACSIL
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:KAHREN
Other - Middle Name:
Other - Last Name:DY-PATACSIL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:4813 S EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6188
Mailing Address - Country:US
Mailing Address - Phone:725-231-9260
Mailing Address - Fax:833-749-0364
Practice Address - Street 1:4813 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6188
Practice Address - Country:US
Practice Address - Phone:725-231-9260
Practice Address - Fax:833-749-0364
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-12
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN002441363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily