Provider Demographics
NPI:1861499733
Name:KRISTENSEN, ANNE E (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:E
Last Name:KRISTENSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8571 W LAKE MEAD BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-7644
Mailing Address - Country:US
Mailing Address - Phone:702-360-5194
Mailing Address - Fax:702-319-4754
Practice Address - Street 1:8571 W LAKE MEAD BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-7644
Practice Address - Country:US
Practice Address - Phone:702-360-5194
Practice Address - Fax:702-319-4754
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8347207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCS09044OtherNV ST BD OF PHARMACY ID#
NV8347OtherNV ST. BD OF MED. LICENSE
NV8347OtherNV ST. BD OF MED. LICENSE
NVCS09044OtherNV ST BD OF PHARMACY ID#
NV8347OtherNV ST. BD OF MED. LICENSE