Individual
LARA CHRISTINE WENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1302 W CRAIG RD STE A, N LAS VEGAS, NV 89032-0247
(702) 473-8380
(702) 473-8383
Mailing address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 216-3346
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10220
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10220
STATE LICENSE
NV
05
—
1164529350
—
NV
Enumeration date
09/20/2006
Last updated
10/20/2022
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