MEDICARE: ALEXUS TIERRA NOBLES RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	885775	NV

General Provider Information

NPI Number	:	1043022866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXUS TIERRA NOBLES RN

Provider Business Mailing Address
First Line	:	9100 W FLAMINGO RD UNIT 2082
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-6419
Country	:	US
Telephone Number	:	702-849-8227
Fax Number	:

Provider Business Practice Location Address
First Line	:	9100 W FLAMINGO RD UNIT 2082
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-6419
Country	:	US
Telephone Number	:	702-849-8227
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2025
Last Update Date	:	01/21/2025

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