Provider Demographics
NPI:1801931761
Name:CANSLER, KATHLEEN CROSBY (MD)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:CROSBY
Last Name:CANSLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6935 ALIANTE PKWY # 104557
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-5818
Mailing Address - Country:US
Mailing Address - Phone:702-726-7230
Mailing Address - Fax:702-726-7171
Practice Address - Street 1:3824 S JONES BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-2453
Practice Address - Country:US
Practice Address - Phone:702-726-7171
Practice Address - Fax:702-726-7171
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV9383207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019190Medicaid
NVV37084Medicare ID - Type Unspecified
NV002019190Medicaid