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Individual

VANESSA KHALIFA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191
(702) 653-3202
Mailing address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191
(702) 653-3202

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
77786
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
77786
LICENSE
CA
Enumeration date
06/15/2018
Last updated
07/11/2018
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