1700266343 NPI number — MS. CHRISTINE ALFREDA NELSON M.S.

Table of content: MS. CHRISTINE ALFREDA NELSON M.S. (NPI 1700266343)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700266343 NPI number — MS. CHRISTINE ALFREDA NELSON M.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NELSON
Provider First Name:
CHRISTINE
Provider Middle Name:
ALFREDA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KEAHL
Provider Other First Name:
CHRISTINE
Provider Other Middle Name:
ALFREDA
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1700266343
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/02/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5307 EAST US. HIGHWAY 95
Provider Second Line Business Mailing Address:
SPC 129
Provider Business Mailing Address City Name:
AMARGOSA VALLEY
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89020-1539
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-764-2145
Provider Business Mailing Address Fax Number:
702-570-5062

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3530 E FLAMINGO RD
Provider Second Line Business Practice Location Address:
STE. 140
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89121-5069
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-570-5421
Provider Business Practice Location Address Fax Number:
702-570-5062
Provider Enumeration Date:
06/08/2015

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: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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