Provider Demographics
NPI:1255908695
Name:KOKSENG, CHARISSE LACHICA (NP-C, WCS-C, EDS-C)
Entity type:Individual
Prefix:MRS
First Name:CHARISSE
Middle Name:LACHICA
Last Name:KOKSENG
Suffix:
Gender:
Credentials:NP-C, WCS-C, EDS-C
Other - Prefix:
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Mailing Address - Street 1:9490 VETERANS CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-4631
Mailing Address - Country:US
Mailing Address - Phone:702-867-0800
Mailing Address - Fax:866-384-4453
Practice Address - Street 1:9490 VETERANS CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-4631
Practice Address - Country:US
Practice Address - Phone:702-867-0800
Practice Address - Fax:866-384-4453
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-04
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV841867363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily