1063983682 NPI number — CHRISTINA GALON NP, APRN

Table of content: CHRISTINA GALON NP, APRN (NPI 1063983682)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063983682 NPI number — CHRISTINA GALON NP, APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GALON
Provider First Name:
CHRISTINA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP, APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALEXANDER, CASEY
Provider Other First Name:
CHRISTINA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1063983682
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/31/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1691 W HORIZON RIDGE PKWY 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HENDERSON
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89012-3520
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-450-8485
Provider Business Mailing Address Fax Number:
702-804-1222

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7751 W FLAMINGO RD
Provider Second Line Business Practice Location Address:
A100
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89147-4399
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-804-6555
Provider Business Practice Location Address Fax Number:
702-804-1273
Provider Enumeration Date:
12/07/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2100X , with the licence number:  816239 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1063983682 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".




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