Provider Demographics
NPI: | 1649915877 |
---|---|
Name: | RAMOS, CHRISTINE |
Entity type: | Individual |
Prefix: | MRS |
First Name: | CHRISTINE |
Middle Name: | |
Last Name: | RAMOS |
Suffix: | |
Gender: | F |
Credentials: | |
Other - Prefix: | MISS |
Other - First Name: | CHRISTINE |
Other - Middle Name: | RESONABLE |
Other - Last Name: | ACAIN |
Other - Suffix: | |
Other - Last Name Type: | Former Name |
Other - Credentials: | RN |
Mailing Address - Street 1: | PO BOX 90712 |
Mailing Address - Street 2: | |
Mailing Address - City: | HENDERSON |
Mailing Address - State: | NV |
Mailing Address - Zip Code: | 89009-0712 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 702-888-4784 |
Mailing Address - Fax: | 702-690-2973 |
Practice Address - Street 1: | 4055 SPENCER ST STE 106 |
Practice Address - Street 2: | |
Practice Address - City: | LAS VEGAS |
Practice Address - State: | NV |
Practice Address - Zip Code: | 89119-5250 |
Practice Address - Country: | US |
Practice Address - Phone: | 702-780-6200 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2022-05-02 |
Last Update Date: | 2024-09-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NV | 852464 | 363LA2100X, 363LP0808X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Multi-Specialty |
No | 363LA2100X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | Group - Multi-Specialty |