Individual
MRS. IVANA P. FUKUMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2350 CORPORATE CIR STE 201, HENDERSON, NV 89074-7737
(702) 562-8900
(702) 407-0266
Mailing address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 216-3346
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN001217
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114234630
—
NV
01
—
APRN001217
LICENSE
NV
Enumeration date
09/03/2010
Last updated
05/21/2026
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