Individual
JOHN KVIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
888 S RANCHO DR, LAS VEGAS, NV 89106-3831
(702) 877-5108
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 838-8265
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
595
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3102268
—
NV
01
—
V34751
SMA MEDICARE REVALIDATION
NV
Enumeration date
09/14/2006
Last updated
12/16/2024
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