Provider Demographics
NPI:1124613047
Name:KULBACK, CRISTINA (APRN)
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:KULBACK
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:CRISTINA
Other - Middle Name:
Other - Last Name:KULBACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:10613 ADOBE RANCH ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-7005
Mailing Address - Country:US
Mailing Address - Phone:702-569-9098
Mailing Address - Fax:
Practice Address - Street 1:10925 S EASTERN AVE STE 120
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-5214
Practice Address - Country:US
Practice Address - Phone:702-992-3688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-02
Last Update Date:2025-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV837848363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily