Provider Demographics
NPI:1740170133
Name:GIRNUS, JUSTIN (FNP-BC)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:GIRNUS
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1836 NAVAJO LAKE WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-3291
Mailing Address - Country:US
Mailing Address - Phone:702-818-0460
Mailing Address - Fax:
Practice Address - Street 1:731 S RAINBOW BLVD STE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-6241
Practice Address - Country:US
Practice Address - Phone:702-202-2012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV883882363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily