Provider Demographics
NPI:1407443872
Name:QUIEN, KIMBERLY BLYTHE ALANIS (RN, CNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY BLYTHE
Middle Name:ALANIS
Last Name:QUIEN
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 ROSSINI ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-5552
Mailing Address - Country:US
Mailing Address - Phone:702-525-5845
Mailing Address - Fax:
Practice Address - Street 1:8930 W SUNSET RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5009
Practice Address - Country:US
Practice Address - Phone:702-489-3345
Practice Address - Fax:702-489-5744
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV835058363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily