Provider Demographics
NPI:1427660992
Name:SHIGIHARA, LARA KRISTINA (MSN, APRN, NP-C)
Entity type:Individual
Prefix:
First Name:LARA
Middle Name:KRISTINA
Last Name:SHIGIHARA
Suffix:
Gender:F
Credentials:MSN, APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5975 S LOS ALTOS PKWY
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-7699
Mailing Address - Country:US
Mailing Address - Phone:775-204-4000
Mailing Address - Fax:775-234-4605
Practice Address - Street 1:5975 S LOS ALTOS PKWY
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-7699
Practice Address - Country:US
Practice Address - Phone:775-204-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV829121363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care