Individual
CAROL ANN KRISAN M OMANDAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
8680 W CHEYENNE AVE, LAS VEGAS, NV 89129-7458
(702) 750-3425
Mailing address
PO BOX 98978, LAS VEGAS, NV 89193-8978
(702) 216-3346
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN002773
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033613203
—
NV
01
—
APRN002773
STATE LICENSE
NV
Enumeration date
03/21/2018
Last updated
06/07/2023
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