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Individual

KSENIA A STAFEEVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2020 WELLNESS WAY STE 402, LAS VEGAS, NV 89106-4145
(702) 485-5000
(702) 485-5005
Mailing address
2020 WELLNESS WAY STE 402, LAS VEGAS, NV 89106-4145
(702) 485-5000
(702) 485-5001

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
14891
NV
207W00000X
Ophthalmology Physician
A121489
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1689838427
NV
Enumeration date
07/10/2008
Last updated
01/03/2024
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