Provider Demographics
NPI:1528705357
Name:CERVANTES, CHRISTIAN BENJAMIN (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:BENJAMIN
Last Name:CERVANTES
Suffix:
Gender:M
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 PUERTA DEL SOL DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89138-6058
Mailing Address - Country:US
Mailing Address - Phone:702-408-8684
Mailing Address - Fax:
Practice Address - Street 1:10624 S EASTERN AVE STE A955
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2982
Practice Address - Country:US
Practice Address - Phone:702-800-5393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-13
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV810847363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily