MEDICARE: EDWARD ALABANZA

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	363LF0000X	Family Nurse Practitioner	833469	NV
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	833469	NV

General Provider Information

NPI Number	:	1730860396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWARD ALABANZA

Provider Business Mailing Address
First Line	:	6216 WINSTON FALLS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-6869
Country	:	US
Telephone Number	:	408-480-3690
Fax Number	:

Provider Business Practice Location Address
First Line	:	302 E CARSON AVE STE 1004
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-5909
Country	:	US
Telephone Number	:	775-400-9764
Fax Number	:

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

Provider Enumeration Date	:	07/27/2023
Last Update Date	:	04/07/2025

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Directions to “ EDWARD ALABANZA ” Practice Location

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