Provider Demographics
NPI:1134997273
Name:DADO, KATRINA
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:DADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATRINA CHRYSELLE
Other - Middle Name:
Other - Last Name:DADO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:6920 NOAH RAVEN ST
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-4032
Mailing Address - Country:US
Mailing Address - Phone:702-470-5128
Mailing Address - Fax:
Practice Address - Street 1:6920 NOAH RAVEN ST
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-4032
Practice Address - Country:US
Practice Address - Phone:702-470-5128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV873470363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner