Provider Demographics
NPI:1497578074
Name:RASZEJA, KRISTEN STARR
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:STARR
Last Name:RASZEJA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 MORNING WIND LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7305
Mailing Address - Country:US
Mailing Address - Phone:702-764-3478
Mailing Address - Fax:
Practice Address - Street 1:3300 MORNING WIND LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-7305
Practice Address - Country:US
Practice Address - Phone:702-764-3478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11592225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist