Provider Demographics
NPI:1508554163
Name:FOTI, KRISTINA (APRN)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:FOTI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2880 BICENTENNIAL PKWY STE 100
Mailing Address - Street 2:PMB 200
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89044-4484
Mailing Address - Country:US
Mailing Address - Phone:702-834-7300
Mailing Address - Fax:702-902-2400
Practice Address - Street 1:3041 W HORIZON RIDGE PKWY STE 165
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-5061
Practice Address - Country:US
Practice Address - Phone:702-834-7300
Practice Address - Fax:702-902-2400
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV865921363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner