Basic Information
Provider Information
NPI: 1780292011
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HSIEH KINSER
FirstName: TING TING
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MSN, APRN, A-GNP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1470 E CALVADA BLVD STE 100
Address2:  
City: PAHRUMP
State: NV
PostalCode: 890483906
CountryCode: US
TelephoneNumber: 7752108333
FaxNumber: 7753469158
Practice Location
Address1: 1460 E CALVADA BLVD
Address2:  
City: PAHRUMP
State: NV
PostalCode: 890485822
CountryCode: US
TelephoneNumber: 7752108333
FaxNumber: 7753469158
Other Information
ProviderEnumerationDate: 07/22/2020
LastUpdateDate: 03/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/21/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN90652NVN Nursing Service ProvidersRegistered Nurse 
363L00000X833038NVY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


Home