Provider Demographics
NPI:1427196708
Name:VANNUCCI, CHRISTOPHER (PA-C)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:
Last Name:VANNUCCI
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2505 ANTHEM VILLAGE DR
Mailing Address - Street 2:SUITE E-625
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-5505
Mailing Address - Country:US
Mailing Address - Phone:702-932-0606
Mailing Address - Fax:702-932-0605
Practice Address - Street 1:866 SEVEN HILLS DR
Practice Address - Street 2:SUITE 203
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4374
Practice Address - Country:US
Practice Address - Phone:702-932-0606
Practice Address - Fax:702-932-0605
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVPA950363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical