Provider Demographics
NPI:1760131320
Name:LAGSTEIN, NICOLE (DPM)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:
Last Name:LAGSTEIN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 CHAMPIONSHIP CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-0513
Mailing Address - Country:US
Mailing Address - Phone:702-376-1134
Mailing Address - Fax:
Practice Address - Street 1:3000 W CHARLESTON BLVD STE 6
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1940
Practice Address - Country:US
Practice Address - Phone:702-878-5252
Practice Address - Fax:702-878-1963
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2122213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist