Provider Demographics
NPI:1831853159
Name:MEDRANO WEINRICK, CHRISTINA MARIE CAMAT
Entity type:Individual
Prefix:
First Name:CHRISTINA MARIE
Middle Name:CAMAT
Last Name:MEDRANO WEINRICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:MEDRANO
Other - Last Name:WEINRICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:370251, 1611 SPRING GATE LANE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134
Mailing Address - Country:US
Mailing Address - Phone:702-738-1373
Mailing Address - Fax:
Practice Address - Street 1:145 E WARM SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-4101
Practice Address - Country:US
Practice Address - Phone:702-659-9090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-22
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV837570363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner