Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | DO1969 | NV |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | DO1969 | NV |
NPI | 1316126758 |
---|---|
Provider Name | Dr. Christine Marie Estrada |
First Address | Henderson, NV 89052-3039 |
Second Address | Las Vegas, NV 89118-3302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2007 |
Last Update Date | 20/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PENDING | (05) | NV |