Provider Demographics
NPI:1992360598
Name:ANDRES, KRISTINE JENNIFER NAVAL (APRN)
Entity Type:Individual
Prefix:
First Name:KRISTINE JENNIFER
Middle Name:NAVAL
Last Name:ANDRES
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 1:8061 BOSCO BAY AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-6635
Mailing Address - Country:US
Mailing Address - Phone:702-606-3731
Mailing Address - Fax:
Practice Address - Street 1:1601 E FLAMINGO RD STE E18
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5244
Practice Address - Country:US
Practice Address - Phone:702-958-0996
Practice Address - Fax:702-965-2216
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-08
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV819061363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily