Provider Demographics
NPI:1932640778
Name:GIREESH, GINI
Entity Type:Individual
Prefix:
First Name:GINI
Middle Name:
Last Name:GIREESH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GINI
Other - Middle Name:
Other - Last Name:KURIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7391 W CHARLESTON BLVD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-1501
Mailing Address - Country:US
Mailing Address - Phone:702-304-2144
Mailing Address - Fax:
Practice Address - Street 1:7391 W CHARLESTON BLVD STE 140
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-1577
Practice Address - Country:US
Practice Address - Phone:702-304-2144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN002478363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner