MEDICARE: ALEXANDRA ANGELICA VASQUEZ 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	163W00000X	Registered Nurse	896745	NV
2	163W00000X	Registered Nurse	1058223	TX

General Provider Information

NPI Number	:	1396604054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA ANGELICA VASQUEZ RN

Provider Business Mailing Address
First Line	:	8955 S TENAYA WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-6243
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6280 S VALLEY VIEW BLVD STE 120
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-3814
Country	:	US
Telephone Number	:	702-478-9934
Fax Number	:

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

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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