Provider Demographics
NPI:1104595172
Name:BENKIRANE, SOUKAINA (PTA)
Entity type:Individual
Prefix:
First Name:SOUKAINA
Middle Name:
Last Name:BENKIRANE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3870 W ANN RD STE 110
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-4412
Mailing Address - Country:US
Mailing Address - Phone:702-396-7100
Mailing Address - Fax:
Practice Address - Street 1:3870 W ANN RD STE 110
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-4412
Practice Address - Country:US
Practice Address - Phone:702-396-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-12
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA1415225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant